Variations in Lipid Profile During Critical Illness
Objective: To determine to mean change in levels of Triglycerides (TG), Total cholesterol (TC), High-Density Lipoprotein Cholesterol (HDL-C), and low-density lipoprotein (LDL-C) in critically ill patients at admission,18 hours and 42 hours after
Study Design: Cross-sectional study
Place and Duration of Study: Department of Chemical Pathology & Endocrinology, Armed Forces Institute of Pathology Rawalpindi (AFIP), in collaboration with Military Hospital Rawalpindi (MH), Combined Military Hospital Rawalpindi (CMH) and Armed Forces Institute of Cardiology Rawalpindi (AFIC) Pakistan, from Mar to Sep 2016.
Methodology: A total of Fifty patients admitted to intensive care units of MH, CMH and AFIC for coronary artery disease(CAD), sepsis, burns and cancer were included in the study. Patients on lipid-lowering drugs and post-surgery patients were excluded.TC, HDL-C, LDL-C and TG were analysed on ADVIA 1800 (SIEMENS, Germany).
Results: Fifty patients were included with mean age of 48.12±2.26 years. Parametric analyses revealed significant increase in serum TG levels during hospitalization in critically ill patients in various disease groups (Mean±SD at admission, 18 hours and 42 hours): TG (CNS disorders 1.35±0.18, 1.78±0.24 and 1.22±0.17; CVS 1.92±0.21, 2.15±0.28 ,2.32 ±0.20; sepsis 1.55±0.18,1.38+0.24,1.54+0.17; malignancies 1.24±0.31, 1.28+0.42,1.35+0.30; renal disorders 1.39+0.35,1.82+0.47,1.08+0.33; (p<0.05). TC decreased in sepsis, CVS and cancer patients while increasing in CNS and renal disorders. HDL-C and LDL-C decreased in all diseases as an acute stress response.
Conclusions: During critical illness, TG and LDL-C may change significantly; therefore, they should be monitored and interpreted with extreme care if requested to be performed within the course of the disease.