Abstract：
OBJECTIVE: Cardiac surgery, post-cardiotomy cardiogenic shock (PCCS), and temporary mechanical circulatory support (tMCS) provoke substantial inflammation. We therefore investigated whether a selenium-based, anti-inflammatory strategy would benefit PCCS patients treated with tMCS in a post-hoc analysis of the sustain CSX trial.
METHODS: Post-hoc analysis of patients receiving tMCS for PCCS in the Sustain CSX trial, which investigated the effects of high-dose selenium on postoperative organ dysfunction in cardiac surgery patients.
METHODS: duration of tMCS therapy.
RESULTS: postoperative organ dysfunction and 30-day mortality.
RESULTS: Thirty-nine patients were treated with tMCS for PCCS. There was no difference in the median duration of tMCS between the selenium and the placebo group (3 days [IQR: 1-6] vs. 2 days [IQR: 1-7], p = 0.52). Median dialysis duration was longer in the selenium group (1.5 days [0-21.8] vs. 0 days [0-1.8], p = 0.048). There was no difference in 30-day mortality (53% vs. 41%, OR 1.44, 95% CI 0.32-6.47, p = 0.62).
CONCLUSIONS: In this explorative study, a perioperative high-dose selenium-supplementation did not show beneficial effects on organ dysfunctions and mortality rates in patients with PCCS receiving tMCS.
METHODS: Post-hoc analysis of patients receiving tMCS for PCCS in the Sustain CSX trial, which investigated the effects of high-dose selenium on postoperative organ dysfunction in cardiac surgery patients.
METHODS: duration of tMCS therapy.
RESULTS: postoperative organ dysfunction and 30-day mortality.
RESULTS: Thirty-nine patients were treated with tMCS for PCCS. There was no difference in the median duration of tMCS between the selenium and the placebo group (3 days [IQR: 1-6] vs. 2 days [IQR: 1-7], p = 0.52). Median dialysis duration was longer in the selenium group (1.5 days [0-21.8] vs. 0 days [0-1.8], p = 0.048). There was no difference in 30-day mortality (53% vs. 41%, OR 1.44, 95% CI 0.32-6.47, p = 0.62).
CONCLUSIONS: In this explorative study, a perioperative high-dose selenium-supplementation did not show beneficial effects on organ dysfunctions and mortality rates in patients with PCCS receiving tMCS.
摘要：
目的：心脏手术，心源性休克（PCCS），和临时机械循环支持（tMCS）引起实质性炎症。因此，我们调查了基于硒的，在CSX持续试验的事后分析中,抗炎策略将使接受tMCS治疗的PCCS患者受益.
方法：在SustainCSX试验中对接受tMCS治疗PCCS的患者进行事后分析，研究了大剂量硒对心脏手术患者术后器官功能障碍的影响。
方法：tMCS治疗的持续时间。
结果：术后器官功能障碍和30天死亡率。
结果：39例患者接受tMCS治疗PCCS。硒和安慰剂组之间tMCS的中位持续时间没有差异（3天[IQR：1-6]与2天[IQR：1-7]，p=0.52）。硒组的透析持续时间中位数更长（1.5天[0-21.8]vs.0天[0-1.8]，p=0.048)。30天死亡率没有差异(53%与41%,OR1.44，95%CI0.32-6.47，p=0.62）。
结论：在这项探索性研究中，在接受tMCS的PCCS患者中,围手术期大剂量补硒未显示出对器官功能障碍和死亡率的有益影响.
方法：在SustainCSX试验中对接受tMCS治疗PCCS的患者进行事后分析，研究了大剂量硒对心脏手术患者术后器官功能障碍的影响。
方法：tMCS治疗的持续时间。
结果：术后器官功能障碍和30天死亡率。
结果：39例患者接受tMCS治疗PCCS。硒和安慰剂组之间tMCS的中位持续时间没有差异（3天[IQR：1-6]与2天[IQR：1-7]，p=0.52）。硒组的透析持续时间中位数更长（1.5天[0-21.8]vs.0天[0-1.8]，p=0.048)。30天死亡率没有差异(53%与41%,OR1.44，95%CI0.32-6.47，p=0.62）。
结论：在这项探索性研究中，在接受tMCS的PCCS患者中,围手术期大剂量补硒未显示出对器官功能障碍和死亡率的有益影响.
