Although there are no reports of adverse effects sellekchem of selenium supplementation for a short period of time in critically ill patients, it is worth considering that high selenium compound concentrations are toxic and that sodium selenite may also act as an oxidant molecule. Adjusted hazard ratios for serum selenium induced all cause mortality among US adults have demonstrated that whereas additional selenium intake may benefit people with low plasma selenium concentrations, Inhibitors,Modulators,Libraries those with adequate to high concentrations might be affected adversely and should not be supplemented. Supplementation with doses around or below the tolerable upper intake should be sufficient to correct previous selenium deficiency in critically ill patients.

Conclusions In this study, Inhibitors,Modulators,Libraries we have shown that the magnitude of the inflammatory Inhibitors,Modulators,Libraries response and malnutrition are associated with low plasma selenium in children admitted to the ICU. There is a significant Inhibitors,Modulators,Libraries interaction between these two factors on plasma selenium concentrations. This interaction should be considered when interpreting plasma concentrations as an index of selenium status in patients with systemic inflammation as well as in the decision on selenium supplementation. Key messages There is an interaction between the magnitude of the inflammatory response and malnutrition on low plasma selenium concentrations in critically ill children. Interaction between variables is present when the effect of one predictor variable on the outcome varies according to the other independent variable. The effect of malnutrition on low plasma selenium depends on CRP concentrations.

At CRP values less than or equal to 40 mg L malnutrition increased the chance of low plasma selenium. This effect decreased according to the CRP concentration increase and was no longer significant from values 40 mg L. On Inhibitors,Modulators,Libraries its turn, the effect of CRP concentrations on low plasma selenium depends selleck Ruxolitinib on whether the child is malnourished or not. This effect was significant in well nourished but not in malnourished patients. The interaction between CRP and malnutrition should be considered when interpreting plasma concentrations as an index of selenium status in patients with systemic inflammation as well as in the decision on selenium supplementation. Introduction Sepsis is a major cause of morbidity and mortality in critically ill patients. Early and adequate antibiotic therapy in this population is crucial to maximize chances of survival. B lactam antibiotics are widely used as first line therapy in septic patients and are particularly effective against bacteria less susceptible to other antibiotics, such as Pseudomonas aeruginosa.