Selenase® In Resuscitation

Scientific information On

Resuscitation

Causes Of Ischaemia:

Cardiac / circulatory arrest due to:
Coronary heart disease/coronary infarction (70 – 80%)
Cardiomyopathy, myocarditis (10 – 15%)
Other causes

Risks After Reperfusion:

Specific damage to heart, lung and brain tissue
Hyperinflammation (= post resuscitation, sepsis-like syndrome)
Endothelial damage

Conventional Measures To Reduce Tissue Damage:

Cardiac massage (earliest possible)
Cardiac massage : ventilation → 30:2
Volume replacement, vasoactive substances → however, up to date not sufficiently effective

Data On Selenium (Selenite, Some With Selenase®):

SIRS / sepsis patients have low selenium levels, this correlates with the severity of the disease [Sakr et al. British Journal of Anaesthesia 98 (2007) 775-784]
Selenium supplementation reduces mortality in SIRS/sepsis patients (SIC) [Angstwurm et al. Crit Care Med 35 (2007) 19]
Selenium significantly improves neurological survival in patients with cardiac arrest [Reisinger et al. European Society of Cardiology (ESC) Congress Vienna 2007]
High doses of selenium (100 g/kg) protects from neurodegeneration (animal model) [Ansari et al. Biological Trace Element Research 101 (2004) 73-86]
High doses of selenium (100 g/kg) reduce cerebral cell death after ischaemia / reperfusion (animal model) [Yousuf et al. Brain Research 1141 (2007) 218-225] · Selenium levels are significantly reduced in patients after cardiac / circulatory arrest [Busch et al. DIVI (2008)]

Possible Actions Of Selenium Supplementation:

Reduction of tissue damage in heart, lungs and brain, i.e. improved neurological outcome
Prevention or minimisation of systemic inflammation (SIRS)

Suggested Timing And Dosage For Selenium Supplementation:

Time point	Dosage
Bolus dose immediately upon transfer of the patient into ambulance	1000 g Se/d as selenase® solution for injection
Bolus dose on admission to catheter lab	1000 g Se/d as selenase® solution for injection
Continuous infusion over 4 days	1000 g Se/d as selenase® solution for injection

Information sheet on PLASTIC SURGERY, biosyn Arzneimittel GmbH, RSi 2008. According to a lecture given by Prof Dr med H Homann, Thieme Workshop 2008 entitled “Ischaemia and reperfusion an interdisciplinary challenge”. For personal use only.

Abbreviated Prescribing Information

selenase® 100 micrograms, solution for injection (50 micrograms/ml)
selenase® 500 micrograms, solution for injection (50 micrograms/ml)

Active ingredient: sodium selenite pentahydrate.
Composition: Each 2 ml ampoule/10 ml injection vial contains 100 micrograms/500 micrograms selenium as 333 micrograms/ 1.66mg sodium selenite pentahydrate (Na2SeO3 x 5H2O), corresponding to 50 micrograms/ml.
Excipients: Sodium chloride, hydrochloric acid, Water for Injections.
Indication: Proven selenium deficiency that cannot be offset from food sources.
Posology and Administration: selenase® solution for injection is administered as an intramuscular or intravenous injection at a daily dose of 100 200 g (1.27 2.53 mol) selenium. If necessary, this dose can be increased to 500 g (6.33 mol) for a typical adult. No dosage adjustment is required for paediatric, renal or hepatic impairment patients.
Contraindications: Selenosis.
Interactions: Ensure that the pH value does not fall below 7.0 and that the solution is not mixed with reducing substances (e.g. vitamin C).
Pregnancy and Lactation: There are no data from the use of selenase® in pregnant or lactating women.
Undesirable Effects: None known to date when used as directed.
Overdose: Counter measures include gastric lavage, forced diuresis, dialysis or administration of high doses of vitamin C.
Pharmaceutical Precautions: Store below 25ºC.
Legal Category: POM.
Presentation: Cartons containing 10 x 2ml ampoules / 10 x10ml glass vials for single use.
MA Numbers: PL 20437/0003, PL 20437/0004.
MA Holder: biosyn Arzneimittel GmbH, Schorndorfer Str 32, D-70734 Fellbach, Germany.
Date of Preparation: November 2004