Selensubstitution bei schweren entzündlichen chirurgischen Krankheitsbildern sowie Verbrennungen und Verbrühungen im Kindesalter

Summary

□Patients and Method: Substitution of selenium was performed in the University Clinic of Paediatric Surgery in Dresden in the time from 1994 to 1996 in 34 children aged 1 to 16 years with severe inflammatory surgical diseases as well as widespread burns. Seven further patients have been examined within this time who have not received substitution of selenium as preliminary comparison group. All these patients fulfilled the criteria of “Systemic Inflammatory Response Syndrome” (SIRS). The following paraclinical parameters were examined: white cell count, interleukin 6, C-reactive protein, fibrinogen, malondialdehyde, activity of glutathione peroxidase in plasma and level of selenium in plasma and whole blood.

□Results: Patients with initially low level of selenium who received substitution of selenium reached normal ranges more quickly than patients without substitution. Originally partly elavated values of malondialdehyde as sign of increased peroxidation of lipids were normalized under substitution of selenium. Initially low activity of selenium level in plasma showed a clear increase under substitution of selenium as sign of increased protection of the cell membrane.

□Conclusion: The substitution of selenium in children with SIRS is a supportive therapy.