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The following is a summary of “Treatment effect of intravenous high-dose selenium in sepsis phenotypes: a retrospective analysis of a large multicenter randomized controlled trial,” published April 2025 issue of Journal of Intensive Care by Radke et al. 

Researchers conducted a retrospective study to explore potential treatment differences of high-dose intravenous selenium based on established sepsis phenotypes using data from the Sodium Selenite and Procalcitonin Guided Antimicrobial Therapy in Severe Sepsis (SISPCT) trial.  

They performed a secondary data analysis of the SISPCT trial, including all 1089 individuals and assigned the participants to 1 of 4 phenotypes by comparing clinical variables with the Sepsis Endotyping in Emergency Care (SENECA) validation cohort and survival analyses was pefrormed using Kaplan–Meier curves and log-rank tests.  

The results showed no significant effect of selenium on mortality or other outcome parameters across any sepsis phenotype. Phenotype frequencies differed notably in the cohort (α: 2.2%, β: 6.3%, γ: 68.0%, δ: 23.4%) compared to previous studies. Mortality differences between phenotypes were not significant overall, but 28-day mortality was lowest for the α- (20.8%) and β-phenotype (20.3%), followed by the γ- (27.1%) and δ-phenotype (28.5%). 

Investigators concluded that applying the 4 sepsis phenotypes to the SISPCT study cohort revealed discrete, but non-significant 28-day mortality differences and high-dose intravenous selenium’s beneficial treatment effects remained undetectable within these phenotype categories. 

Source: jintensivecare.biomedcentral.com/articles/10.1186/s40560-025-00790-2