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Tanaka S, Labreuche J, Drumez E, et al. Low HDL levels in sepsis versus trauma patients in intensive care unit. Ann Intensive Care. 2017;7(1):60doi: 10.1186/s13613-017-0284-3.
Tanaka, S., Labreuche, J., Drumez, E., Harrois, A., Hamada, S., Vigué, B., Couret, D., Duranteau, J., & Meilhac, O. (2017). Low HDL levels in sepsis versus trauma patients in intensive care unit. Annals of intensive care, 7(1), 60. https://doi.org/10.1186/s13613-017-0284-3
Tanaka, Sébastien, et al. "Low HDL levels in sepsis versus trauma patients in intensive care unit." Annals of intensive care vol. 7,1 (2017): 60. doi: https://doi.org/10.1186/s13613-017-0284-3
Tanaka S, Labreuche J, Drumez E, Harrois A, Hamada S, Vigué B, Couret D, Duranteau J, Meilhac O. Low HDL levels in sepsis versus trauma patients in intensive care unit. Ann Intensive Care. 2017 Dec;7(1):60. doi: 10.1186/s13613-017-0284-3. Epub 2017 Jun 06. PMID: 28589535; PMCID: PMC5461227.
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Ann Intensive Care. 2017 Dec;7(1):60. doi: 10.1186/s13613-017-0284-3. Epub 2017 Jun 06.

Low HDL levels in sepsis versus trauma patients in intensive care unit.

Annals of intensive care

Sébastien Tanaka, Julien Labreuche, Elodie Drumez, Anatole Harrois, Sophie Hamada, Bernard Vigué, David Couret, Jacques Duranteau, Olivier Meilhac

Affiliations

  1. Assistance Publique des Hopitaux de Paris, Service d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Hôpital de Bicêtre, le Kremlin-Bicêtre, France. [email protected].
  2. Département de biostatistique, Université de Lille, CHU Lille, EA 2694 - Santé publique, épidémiologie et qualité des soins, 59000, Lille, France.
  3. Assistance Publique des Hopitaux de Paris, Service d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Hôpital de Bicêtre, le Kremlin-Bicêtre, France.
  4. Laboratoire d'étude de la Microcirculation, « Bio-CANVAS: biomarqueurs in CardioNeuroVascular DISEASES », UMRS 942, Paris, France.
  5. Université de La Réunion, INSERM, UMR 1188 Diabète athérothombose Réunion Océan Indien (DéTROI), Saint-Denis, France.
  6. CHU de La Réunion, Saint-Denis, France.

PMID: 28589535 PMCID: PMC5461227 DOI: 10.1186/s13613-017-0284-3

Abstract

BACKGROUND: The protective cardiovascular effect of high-density lipoproteins (HDLs) is considered to chiefly rely on reverse cholesterol transport from peripheral tissues back to the liver. However, HDL particles display pleiotropic properties, including anti-inflammatory, anti-apoptotic or antioxidant functions. Some studies suggest that HDL concentration decreases during sepsis, and an association was reported between low HDL levels and a poor outcome. Like sepsis, trauma is also associated with a systemic inflammatory response syndrome. However, no study has yet explored changes in lipid profiles during trauma. We sought to compare lipid profiles between sepsis and trauma patients in intensive care unit (ICU). In septic patients, we analyzed the association between lipid profile, severity and prognosis.

METHODS: A prospective, observational, single-centered study was conducted in a surgical ICU. For each patient, total cholesterol, HDL, triglyceride and low-density lipoprotein cholesterol levels were assessed at admission. Short-term prognosis outcome was prospectively assessed.

RESULTS: Seventy-five consecutive patients were admitted (50 sepsis and 25 trauma). There was no difference in SOFA and SAPSII scores between the two groups. Patients with sepsis had lower total cholesterol levels than patients with trauma. Regarding the lipoprotein profile, only HDLs differed significantly between the two groups (median [IQR] = 0.33 mmol/l [0.17-0.78] in sepsis patients versus median [IQR] = 0.99 mmol/l [0.74-1.28] in trauma patients; P < 0.0001). Whereas ICU mortality was not associated with lipid levels in the sepsis group, a significant negative correlation was found between HDL concentration and the length of ICU stay (r = -0.35; P = 0.03) in the group of survivor septic patients at ICU discharge. In addition, poor outcome defined as death or a SOFA score >6 at day 3 was associated with lower HDL levels (median [IQR] = 0.20 mmol/l [0.11-0.41] vs. 0.35 mmol/l [0.19-0.86] in patients with poor outcome versus others; P = 0.03).

CONCLUSIONS: Lipid profile was totally different between sepsis and trauma in ICU patients: HDL levels were low in septic patients, whereas their concentration was not altered in trauma patients. This major difference reinforces the necessity to explore the therapeutic potential of HDL in sepsis.

Keywords: High-density lipoproteins; ICU; Inflammation; Lipids; Outcome; Sepsis; Trauma

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