Dyslipidemia: a prospective controlled randomized trial of intensive glycemic control in sepsis
| Autor: | Rui Curi, Irineu Tadeu Velasco, Danilo Teixeira Noritomi, Francisco Garcia Soriano, Tatiana Carolina Alba Loureiro, Sylas B. Cappi |
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| Rok vydání: | 2012 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Enzyme-Linked Immunosorbent Assay Fatty Acids Nonesterified Critical Care and Intensive Care Medicine Gastroenterology Statistics Nonparametric Sepsis LIPOPROTEÍNAS Internal medicine Intensive care medicine Humans Prospective Studies Triglycerides APACHE Dyslipidemias Glycemic chemistry.chemical_classification medicine.diagnostic_test Septic shock business.industry Fatty acid Middle Aged medicine.disease Lipoproteins LDL Cholesterol Endocrinology chemistry Colorimetry Female Lipoproteins HDL Lipid profile business Dyslipidemia Lipoprotein |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 1432-1238 0342-4642 |
| DOI: | 10.1007/s00134-011-2458-z |
| Popis: | Metabolic disturbances are quite common in critically ill patients. Glycemic control appears to be an important adjuvant therapy in such patients. In addition, disorders of lipid metabolism are associated with worse prognoses. The purpose of this study was to investigate the effects that two different glycemic control protocols have on lipid profile and metabolism. We evaluated 63 patients hospitalized for severe sepsis or septic shock, over the first 72 h of intensive care. Patients were randomly allocated to receive conservative glycemic control (target range 140–180 mg/dl) or intensive glycemic control (target range 80–110 mg/dl). Serum levels of low-density lipoprotein, high-density lipoprotein, triglycerides, total cholesterol, free fatty acids, and oxidized low-density lipoprotein were determined. In both groups, serum levels of low-density lipoprotein, high-density lipoprotein, and total cholesterol were below normal, whereas those of free fatty acids, triglycerides, and oxidized low-density lipoprotein were above normal. At 4 h after admission, free fatty acid levels were higher in the conservative group than in the intensive group, progressively decreasing in both groups until hour 48 and continuing to decrease until hour 72 only in the intensive group. Oxidized low-density lipoprotein levels were elevated in both groups throughout the study period. Free fatty acids respond to intensive glycemic control and, because of their high toxicity, can be a therapeutic target in patients with sepsis. |
| Databáze: | OpenAIRE |
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