Is hyperlipasemia in critically ill patients of clinical importance? An observational CT study.
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.
Denz
Christof
C
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
Siegel
Leonie
L
Lehmann
Karl-Jürgen
KJ
Dagorn
Jean-Charles
JC
Fiedler
Fritz
F
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
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