The Selenium Status of Pediatric Patients With Burn Injuries. Commentary

Background: Dietary selenium (Se) requirements during critical illness are not well known. The objective of this study was to assess the longitudinal Se status of pediatric patients with bums. Methods: Twenty patients admitted to our hospital with bums exceeding 10% of their total body surface area were studied longitudinally during the first 8 weeks of admission or until 95% wound closure was achieved. Dietary Se intake was calculated daily, and plasma and urine samples were collected weekly for analyses of plasma Se, urinary Se, and glutathione peroxidase activity. Results: Patients included in this study were individuals with an average age of 6.5 years ± 5.3 years and with burn injury of a mean total body surface area of 42% ± 21%. Dietary Se intake throughout the study (mean = 60 μg/d ± 39 μg/d) was consistent with established standards for healthy children and did not change throughout the study. Plasma Se (mean = 1.08 μmol/L ± 0.34 μmol/L) and plasma glutathione peroxidase (mean = 3.2 U/g protein ± 1.42 U/g protein) were below reported normal values for healthy American children. Mean urinary Se excretion (65.9 μg/L ± 50 μg/L) exceed dietary Se intake. Plasma Se was inversely related to incidence of total infection (p = 0.04). Conclusions: Results from this study indicate that Se status is depressed among pediatric patients with burns and that recommended Se intake for healthy children is likely insufficient for this population. Further studies are necessary to elucidate the amount of dietary Se required to maximize Se stores among pediatric patients with burn injuries.