title: Is hyperlipasemia in critically ill patients of clinical importance? An observational CT study.
abstract: OBJECTIVE
  To assess morphological alterations of the pancreas by contrast-enhanced computed tomography (cCT) and subclinical cellular damage of the pancreas by measuring pancreatitis-associated protein (PAP) in critically ill patients without prior pancreatic disorder who presented with raised serum lipase levels.
  
  
  METHODS
  Prospective, observational study
  
  
  METHODS
  Mixed surgical/neurosurgical intensive care unit of a German university hospital.
  
  
  METHODS
  One hundred and thirty consecutive critically ill patients without prior damage or disease of the pancreas and an expected length of stay of more than 5 days.
  
  
  METHODS
  Daily serum lipase measurements and daily serum PAP measurements. Contrast-enhanced upper abdominal cCT study in patients with triple increase of serum lipase.
  
  
  RESULTS
  Thirty-eight patients showed raised serum lipase levels and qualified for the cCT scan study. In 20 patients cCT scans were performed. Morphological alterations of the pancreas were found in 7 out these 20 patients while serum PAP levels were raised in all patients.
  
  
  CONCLUSIONS
  Hyperlipasemia is a common finding in critically ill patients without prior pancreatic disorder. While elevated serum PAP levels indicate pancreatic cellular stress morphological alterations of the pancreas are rare and of little clinical importance.
authors.affiliation: University of Heidelberg, Clinic of Anesthesiology and Intensive Care Medicine, University Hospital Mannheim, Faculty of Clinical Medicine Mannheim, 68167 Mannheim, Germany. christof.denz@anaes.ma.uni-heidelberg.de
authors.forename: Christof
authors.initials: C
authors.lastname: Denz
authors.forename: Leonie
authors.initials: L
authors.lastname: Siegel
authors.forename: Karl-Jürgen
authors.initials: KJ
authors.lastname: Lehmann
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Dagorn
authors.forename: Fritz
authors.initials: F
authors.lastname: Fiedler
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D003287:Contrast Media; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007479:Iopamidol / Q000031:analogs & derivatives; D037181:Lectins, C-Type / Q000097:blood*; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000097:blood / Q000000981:diagnostic imaging*; D000073718:Pancreatitis-Associated Proteins; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D003287:Contrast Media; D037181:Lectins, C-Type; D000073718:Pancreatitis-Associated Proteins; C000612141:REG3A protein, human; C057937:iomeprol; D008049:Lipase; D007479:Iopamidol