Pathophysiologic correlates of hypocholesterolemia in critically ill surgical patients.
OBJECTIVE
To assess correlates of hypocholesterolemia in moderate to critical surgical illness.


METHODS
Prospective analysis of laboratory and clinical data.


METHODS
Department of surgery in a university hospital.


METHODS
135 patients undergoing uncomplicated abdominal surgery or with sepsis, liver failure, hemorrhage, severe cholestasis, or multiple organ dysfunction syndrome (MODS).


METHODS
Surgical and/or medical therapy according to clinical status.


RESULTS
Determinations of total cholesterol, additional variables, and clinical data. Cholesterol decreased after surgery, in sepsis, liver failure, acute hemorrhage, and MODS and increased in cholestasis. Hypocholesterolemia correlated with decreases in plasma proteins and indices of hepatic protein synthetic adequacy, with hemodilution from blood loss, and was moderated or prevented by cholestasis.


CONCLUSIONS
These results help to explain the dynamics of the development, clinical relevance, and negative prognostic value of hypocholesterolemia in critical illness.
Giovannini
I
I
Department of Surgery and Surgical ICU (Geriatric Surgery), Catholic University of the Sacred Heart School of Medicine, Rome, Italy.
Boldrini
G
G
Chiarla
C
C
Giuliante
F
F
Vellone
M
M
Nuzzo
G
G
D002784:Cholesterol / Q000097:blood* / Q000172:deficiency*; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
D002784:Cholesterol