Table 1 Bioactive lipids and cytokines measured in sepsis and other critically ill patients correlated with prognosis
From: n-3 fatty acids, γ-linolenic acid, and antioxidants in sepsis
Source of body fluid/tissue | Bioactive lipids to be measured | Time when measured in sepsis/critical illness | Method of measurement | Probable change |
|---|---|---|---|---|
Plasma | PUFAs: LA, GLA, DGLA, AA, ALA, EPA, DHA and their trans-fatty acids | On admission, every 24 hours until discharge or death | GC; LC-MS | GLA, AA, EPA and DHA ↓ at admission; restored to normal if appropriate external supplementation is given; trans-fatty acids ↑ at admission, will decrease if inflammation is contained and indicates relatively good prognosis |
Plasma | Various PGs, LTs, TXs | On admission, every 24 hours until discharge or death | ELISA-HPLC | ↑ in 2-series PGs and TXs, and 4-series LTs indicates inflammatory process is dominant; ↑ in 3-series PGs and TXs, and 5-series LTs indicates that the administered EPA is being converted to these products; to be correlated with levels of lipoxins, resolvins, protectins and maresins; ↓ in 2-series PGs and TXs, and 4-series LTs after GLA/EPA/DHA supplementation indicates decreasing tendency of inflammation |
Plasma | Lipoxins, resolvins, protectins, maresins | On admission, every 24 hours until discharge or death | LC-MS | Lipoxins, resolvins, protectins, maresins ↓ at admission; restored to normal if patient is improving, remain low if prognosis is poor |
Plasma | Nitrolipids | On admission, every 24 hours until discharge or death | LC-MS/MS-MS | Nitrolipids ↓ at admission; restored to normal if patient is improving, remain low if prognosis is poor |
Plasma | Isoprostanes | On admission, every 24 hours until discharge or death | LC-MS/MS-MS | Isoprostanes ↑ at admission; restored to normal if patient is improving, remain high if prognosis is poor |
Plasma | Cytokines | On admission, every 24 hours until discharge or death | ELISA and/or flow cytometric-based immunofluorescence assays | If proinflammatory cytokines ↑, inflammation is dominant; if anti-inflammatory cytokines ↑, recovery process is on the anvil; correlation needs to be made among cytokine profile, bioactive lipids and clinical picture |