The Preventive Role of Selenium in Inflammatory Response During Coronary Artery Bypass Graft Surgery: A Randomized, Controlled Clinical Trial

Coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB) triggers a profound systemic inflammatory response and sympathetic nervous system activation translated into post-operative adverse outcomes. The current study aimed at determining whether preparative use of selenium could reduce the severity of inflammatory reaction to surgery. The current randomized, double-blind clinical trial was conducted at the Department of Cardiac Surgery of Dr. Heshmat Hospital; a referral center affiliated to Guilan University of Medical Sciences (GUMS), Rasht, Iran. From May 2015 to September 2015 one hundred and fourteen patients who were candidates for elective CABG were randomly recruited to receive either an intravenous bolus of 600 µg Se before induction of anesthesia in the group S (n = 56) or normal saline as placebo in the group C (n = 58). To measure white blood cells (WBC) serum levels, blood samples were collected preoperatively (T0) and three times after CPB initiation immediately after the end of CPB (T1), as well as 24 (T2) and 48 hours (T3) after surgery. Statistical tests including chi-square, the Kruskal-Wallis, and independent t tests, as well as repeated measurement ANOVA were used to analyze the data. There was no significant difference between the two groups regarding the baseline characteristics (P = 0.0512). There was no significant difference between the two groups in other four time points; T0 (P = 0.0512), T1 (P = 0.571), T2 (P = 0.974), and T3 (P = 0.215), although the trend of changes was statistically significant in each group (P = 0.0001), the intergroup comparisons showed no significant changes (P = 0.166). There was no strong evidence that a single-dose of Se could reduce inflammation following CABG surgery.