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Copyright (c) 2020 Carlos Tejeda-Jaraba, Akbal Echtay-Martínez, Cristobal Espinoza-Díaz, Ana Herrera-Castillo, Roberto Añez, Juan Salazar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Low High Density Lipoproteins in sepsis: an associated factor with worst prognosis
Corresponding Author(s) : Juan Salazar
Ciencia e Innovación en Salud,
2020
Abstract
Introduction: Sepsis is a frequent disease that cause a high morbidity and mortality in the adult population that consult to the emergency services, the dysregulated inflammatory response that characterizes it can be modulated by high density lipoprotein levels, thus the objective of this study was to determinate the association between high density lipoprotein levels and complications in patients with sepsis diagnosis. Materials and Methods: An observational, prospective study was carried out with a non-experimental design, whose population were 60 subjects of both genders with sepsis diagnosis. The data was collected using a form that included: identification data, clinical data such as: blood pressure, heart rate, respiratory rate, Glasgow coma scale and laboratory data: leukocytes, HDL-C level, creatinine, total bilirubin, platelets, diuresis, PaO2/FiO2, and coagulation profile. Results: Of the total sample, 58.3% (n=35) presented complications such as septic shock or multi-organ failure, with a higher percentage in those with lower HDL-C (HDL-C <30mg/dl: 82.8% vs HDL-C ≥30: 35.5% (χ2=13.78, p<0.01). Similarly, this group required greater use of vasoactive agents (χ2=36.47, p<0.01). While clinical parameters such as systolic blood pressure, Glasgow coma scale, platelets and PaO2 / FiO2 showed a lower average in patients with HDL-C <30 mg/dl Conclusion: Serum levels of HDL-C<30 mg/dl were associated with a higher percentage of patients that evolved to septic shock, requirement of vasoactive agents and multi-organ failure.
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- Singer M, Deutschman C, Warren Seymour C, Shankar-Hari M, Annane D, Bauer M, et al. The Third
- International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810.
- DOI: 10.1001/jama.2016.0287
- Kempker JA., Martin GS. The Changing Epidemiology and Definitions of Sepsis. Clin Chest Med.
- ;37(2):165-79. DOI: 10.1016/j.ccm.2016.01.002
- Biron BM, Lomas-Neira JL. Biomarkers for Sepsis: What Is and What Might Be? Biomark Insights. 2015;
- (Suppl 4): 7–17. DOI: 10.4137/BMI.S29519
- Salazar J, Cabrera M, Ramos E, Olivar L, Aguirre M, Rojas J, et al. HDL-C y riesgo de aterosclerosis.
- Diabetes Internacional. 2013;5(2):42-54.
- Contreras S, Varas P, Awad F, Busso D, Rigotti A. Papel protector de las lipoproteínas de alta densidad en
- sepsis: aspectos básicos e implicancias clínicas. Rev Chilena Infectol. 2004;31 (1): 34-43. DOI: 10.4067/S0716-
- Morin EE, Guo L, Schwendeman A, Li XA. HDL in sepsis - risk factor and therapeutic approach. Front
- Pharmacol. 2015;6:244. DOI: 10.3389/fphar.2015.00244
- Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign:
- International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med.
- ;43(3):304-377. DOI: 10.1007/s00134-017-4683-6
- Murch O, Collin M, Hinds CJ, Thiemermann C. Lipoproteins in inflammation and sepsis. I. Basic science.
- Intensive Care Med. 2007;33(1):13–24. DOI: 10.1007/s00134-006-0432-y
- Behnes M, Brueckmann M, Liebe V, et al. Levels of oxidized low-density lipoproteins are increased in patients
- with severe sepsis. J Crit Care, 2008;23(4):537–41. DOI: 10.1016/j.jcrc.2008.09.002
- Capatano AL, Pirillo A, Bonacina F, Norata GD. HDL in innate and adaptive immunity. Cardiovascular
- Research. 2014;103(3):372–383. DOI: 10.1093/cvr/cvu150
- Norata GD, Pirillo A, Ammirati E, Catapano AL. Emerging role of high density lipoproteins as a player in the
- immune system. Atherosclerosis. 2012;220(1):11–21. DOI: 10.1016/j.atherosclerosis.2011.06.045
- Shor R, Wainstein J, Oz D, Boaz M, Matas Z, Fux A, Halabe A. Low HDL levels and the risk of death, sepsis
- and malignancy. Clin Res Cardiol. 2008;97(4):227-33. DOI: 10.1007/s00392-007-0611-z
- Chien JY, Jerng JS, Yu CJ, Yang PC. Low serum level of high-density lipoprotein cholesterol is a poor
- prognostic factor for severe sepsis. Crit Care Med, 2005;33(8):1688-1693.
- DOI: 10.1097/01.ccm.0000171183.79525.6b
- Rodríguez-Sanz A, Fuentes B, Martínez-Sánchez P, Prefasi D, Martínez-Martínez M, Correas E, et al. High-
- Density Lipoprotein: A Novel Marker for Risk of In-Hospital Infection in Acute Ischemic Stroke Patients Cerebrovasc Dis, 2013; 35(3):291–297. DOI: 10.1159/000347077
- Atogo-Asse, Vincent RP, Hughes SA, Auzinger G, Le Roux CW, Wendon J, Bernal W. High density
- lipoprotein in patients with liver failure; relation to sepsis, adrenal function and outcome of illness. Liver Int.
- ;32(1):128-36. DOI: 10.1111/j.1478-3231.2011.02657.x
References
Singer M, Deutschman C, Warren Seymour C, Shankar-Hari M, Annane D, Bauer M, et al. The Third
International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810.
DOI: 10.1001/jama.2016.0287
Kempker JA., Martin GS. The Changing Epidemiology and Definitions of Sepsis. Clin Chest Med.
;37(2):165-79. DOI: 10.1016/j.ccm.2016.01.002
Biron BM, Lomas-Neira JL. Biomarkers for Sepsis: What Is and What Might Be? Biomark Insights. 2015;
(Suppl 4): 7–17. DOI: 10.4137/BMI.S29519
Salazar J, Cabrera M, Ramos E, Olivar L, Aguirre M, Rojas J, et al. HDL-C y riesgo de aterosclerosis.
Diabetes Internacional. 2013;5(2):42-54.
Contreras S, Varas P, Awad F, Busso D, Rigotti A. Papel protector de las lipoproteínas de alta densidad en
sepsis: aspectos básicos e implicancias clínicas. Rev Chilena Infectol. 2004;31 (1): 34-43. DOI: 10.4067/S0716-
Morin EE, Guo L, Schwendeman A, Li XA. HDL in sepsis - risk factor and therapeutic approach. Front
Pharmacol. 2015;6:244. DOI: 10.3389/fphar.2015.00244
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign:
International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med.
;43(3):304-377. DOI: 10.1007/s00134-017-4683-6
Murch O, Collin M, Hinds CJ, Thiemermann C. Lipoproteins in inflammation and sepsis. I. Basic science.
Intensive Care Med. 2007;33(1):13–24. DOI: 10.1007/s00134-006-0432-y
Behnes M, Brueckmann M, Liebe V, et al. Levels of oxidized low-density lipoproteins are increased in patients
with severe sepsis. J Crit Care, 2008;23(4):537–41. DOI: 10.1016/j.jcrc.2008.09.002
Capatano AL, Pirillo A, Bonacina F, Norata GD. HDL in innate and adaptive immunity. Cardiovascular
Research. 2014;103(3):372–383. DOI: 10.1093/cvr/cvu150
Norata GD, Pirillo A, Ammirati E, Catapano AL. Emerging role of high density lipoproteins as a player in the
immune system. Atherosclerosis. 2012;220(1):11–21. DOI: 10.1016/j.atherosclerosis.2011.06.045
Shor R, Wainstein J, Oz D, Boaz M, Matas Z, Fux A, Halabe A. Low HDL levels and the risk of death, sepsis
and malignancy. Clin Res Cardiol. 2008;97(4):227-33. DOI: 10.1007/s00392-007-0611-z
Chien JY, Jerng JS, Yu CJ, Yang PC. Low serum level of high-density lipoprotein cholesterol is a poor
prognostic factor for severe sepsis. Crit Care Med, 2005;33(8):1688-1693.
DOI: 10.1097/01.ccm.0000171183.79525.6b
Rodríguez-Sanz A, Fuentes B, Martínez-Sánchez P, Prefasi D, Martínez-Martínez M, Correas E, et al. High-
Density Lipoprotein: A Novel Marker for Risk of In-Hospital Infection in Acute Ischemic Stroke Patients Cerebrovasc Dis, 2013; 35(3):291–297. DOI: 10.1159/000347077
Atogo-Asse, Vincent RP, Hughes SA, Auzinger G, Le Roux CW, Wendon J, Bernal W. High density
lipoprotein in patients with liver failure; relation to sepsis, adrenal function and outcome of illness. Liver Int.
;32(1):128-36. DOI: 10.1111/j.1478-3231.2011.02657.x