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Volume 18 Supplement 2

Sepsis 2014

  • Poster presentation
  • Open Access

Presepsis biomarker: high-density lipoprotein

  • S Al-Zaidawi1
Critical Care201418(Suppl 2):P77

https://doi.org/10.1186/cc14080

Published: 3 December 2014

Keywords

LipidAlbuminBlood SampleTriglycerideNormal Level

Introduction

Delay in diagnosis and initiation of antibiotic treatment has been shown to increase mortality. Biomarkers can play an important role in diagnosis and prognosis of sepsis. We aimed to evaluate the correlation between septicemia and high-density lipoprotein (HDL) level in burned patients.

Methods

A prospective study conducted at Al-Sadr teaching hospital, Maysan, Iraq, during the period from April to September 2013. Blood samples were collected from patients every other day to measure the level of HDL and triglycerides. Other blood samples were collected in blood culture tubes for culturing to verify septicemia depending on the clinical evidence.

Results

Seventy-five patients (Table 1) were admitted consecutively into the burn unit, 35 of them (46%) developed septicemia and 11 of the 35 patients died. All dead patients had HDL value <5 mg/dl 1 or 2 days before dying since our blood samples were collected every 2 days (Tables 2 and 3). Other laboratory tests such as WBCs, platelet account, albumin level, and so forth were made to confirm sepsis (Table 4). A comparison between the level of lipid profile before and after sepsis showed a significant drop in HDL level during the onset of sepsis (Table 5). We also found that patients with HDL value <15 mg/dl were at high risk of developing sepsis.
Table 1

Characteristics of patients

Patient characteristic

Average

Range

Age (years)

17

1 to 85

TBSA%

33.5%

15 to 95%

Sex of patients

Female 61%

Male 39%

Burn type

Scalds 48%

Flame 52%

Most patients were female (61%) with average age 17 years and a wide range of burned surface area (15 to 95%)

Table 2

Lipid profile for all 75 patients at the onset of thermal injury during the first day of admission: all patients were with a normal range of HDL, triglycerides and cholesterol

Lipid profile

Range (mg/dl)

Average (mg/dl)

Mode (mg/dl)

Normal range (mg/dl)

HDL

30 to 56

39

38

39 to 59

Triglycerides

37 to 148

70

58

0 to 149

Cholesterol

46 to 155

78

86

0 to 199

Table 3

Lipid profile at the onset of sepsis showed that HDL level dropped to less than 15 mg/dl with range (4 to 13 mg/dl): elevation in triglyceride level out of normal range with no significant change in cholesterol level

Lipid profile

Range (mg/dl)

Average (mg/dl)

Mode (mg/dl)

Normal range (mg/dl)

HDL

4 to 13

7.6

4

39 to 59

Triglycerides

133 to 435

214.5

180

0 to 149

Cholesterol

56 to 139

82.8

76

0 to 199

Table 4

Levels of urea, creatinine, albumin, WBC, platelets during onset of sepsis: most patients developed hypoalbuminemia and thrombocytopenia

 

%TBSA

WBC (×1,000/μl)

Platelet count (×1,000/μl)

Blood urea (mg/dl)

Serum creatinine

Serum albumin (g/dl)

Time to get sepsis (days)

Average

55

11.86

154.9

14

0.51

2.0

7

Mode

45

9.04

121

12

0.37

1.8

10

Minimum

27

2.27

32

9

0.32

1.4

2

Maximum

95

15.03

535

21

0.73

3.1

20

Table 5

Comparison between level of lipid profile before and after sepsis showed the significant dropping in HDL level during onset of sepsis

 

HDL

Triglycerides

Cholesterol

P value

Burn onset

39

70

78

< 0.01

Sepsis onset

7.6

214.5

76

< 0.01

Conclusion

There was a strong correlation between HDL level and septicemia in burn patients. The HDL value is a good biomarker for sepsis; it decreases below normal level and continues to diminish and reach an immeasurable level at the advanced stage of septicemia.

Authors’ Affiliations

(1)
Surgery Department, Burn Unit, Al-Sadr Teaching Hospital, Maysan, Iraq

Copyright

© Al-Zaidawi; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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