Lipid metabolism in critical illness
Purpose of review
This article describes recent findings regarding lipid metabolism in critical illness as well as in lipid therapy.
Recent findings
In critical illness, in the presence of a decrease in lipid absorption, adipose tissue lipolysis raises triglyceride levels. High-density lipoprotein and low-density lipoprotein are decreased because of impairment of lecithin–cholesterol acyltransferase, mainly in sepsis. In septic patients, lipid profile may be a predictor of survival. Nonsurvivors have lower levels of high-density lipoprotein and low-density lipoprotein. In metabolomic studies, most of the changes from baseline in septic patients were related to lipid metabolism. Lysophosphatidylcholine was also significantly lower in nonsurviving septic patients.Summary
Lipid profile results are too often neglected by the clinician despite increasing knowledge in the modifications related to septic state as well as the importance of these values in the prognosis of the critically ill. Lipid administration (enterally or parenterally) should be guided by better knowledge of the lipid metabolism of the patient.
This article describes recent findings regarding lipid metabolism in critical illness as well as in lipid therapy.
Recent findings
In critical illness, in the presence of a decrease in lipid absorption, adipose tissue lipolysis raises triglyceride levels. High-density lipoprotein and low-density lipoprotein are decreased because of impairment of lecithin–cholesterol acyltransferase, mainly in sepsis. In septic patients, lipid profile may be a predictor of survival. Nonsurvivors have lower levels of high-density lipoprotein and low-density lipoprotein. In metabolomic studies, most of the changes from baseline in septic patients were related to lipid metabolism. Lysophosphatidylcholine was also significantly lower in nonsurviving septic patients.
Lipid profile results are too often neglected by the clinician despite increasing knowledge in the modifications related to septic state as well as the importance of these values in the prognosis of the critically ill. Lipid administration (enterally or parenterally) should be guided by better knowledge of the lipid metabolism of the patient.
Keywords: critical illness; fish oil; lipid metabolism
Document Type: Research Article
Affiliations: 1: Felsenstein Medical Research Center, Metabolic Laboratory 2: Nursing Department, Steyer School of Health Professions, General intensive Care Department, Institute for Nutrition Research, Rabin Medical Center, Sackler School of Medicine, Beilinson Hospital, Tel Aviv University, Tel Aviv, Israel 3: Felsenstein Medical Research Center, Metabolic Laboratory, General intensive Care Department, Institute for Nutrition Research, Rabin Medical Center, Sackler School of Medicine, Beilinson Hospital, Tel Aviv University, Tel Aviv, Israel
Publication date: 01 March 2016
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