Lipid metabolism in critically ill patients: a microdialysis study

Abstract

Results Thirty-seven (21 men) critically ill septic patients with a mean (± SD) age of 65 ± 18 years were studied. APACHE and SOFA at study entry were 22 ± 4 and 8 ± 3, respectively. Sepsis was related to SIRS (n = 1), severe sepsis (n = 7) and septic shock (n = 29). Mortality was 43%. Serum cholesterol (81 ± 42 mg/l) along with HDL (16 ± 17 mg/dl) and LDL (63 ± 37 mg/dl) were low. Serum triglycerides (158 ± 91 mg/dl) were elevated and FFAs (0.41 ± 0.27 mmol/l) were within normal limits. Serum glycerol was high (26 ± 20 mmol/l). Interstitial glycerol was also elevated (331 ± 190 μmol/l). Serum FFAs correlated with both serum (r = 0.43, P = 0.009) and interstitial (r = 0.33, P = 0.04) glycerol. Go to: Conclusions Critical care sepsis is characterized by an increase in serum and tissue glycerol and preserved FFA levels; these indicate enhanced lipolysis and an increased FFA uptake by peripheral tissues. Serum or interstitial glycerol are better indices of lipid mobilization than serum FFA levels in mechanically ventilated septic patients.