title: Increased lipase and amilase levels in critically ill patients: retrospective study.
abstract: OBJECTIVE
  Elevated lipase and amylase are commonly found in patients in intensive care unit without a previously recognized pancreatic illness, constituting a diagnostic and therapeutic challenge. The authors therefore proposed to determine the frequency of asymptomatic high serum lipase in critically ill patients, involved risk factors and outcome.
  
  
  METHODS
  Retrospective study of patients admitted in an intensive care unit from January 1 to December 31, 2006, excluding admissions for acute pancreatitis, history of pancreatic disease, renal insufficiency or lacking of data. Patients were divided in two groups (with and without high serum lipase) that were compared for clinical, laboratory and radiological variables.
  
  
  METHODS
  SPSS 13; Student's t test and Chi-square test (CI 95%) with statistical significance if p< 0.05).
  
  
  RESULTS
  102 patients were included with high serum lipase was present in 39.2% of patients, mean lipase of 797U/L. Patients with high serum lipase had longer hospital stay (p< 0.001), parenteral nutrition (p< 0.001), ventilator support (p=0.04), fever (p< 0.001), hyperamylasemia (p<0.05), hyperbilirrubinemia (p=0.003) and rise of transaminases (p=0.001), with no significant differences in diagnosis, gender, age, APACHE II, SOFA, SAPS, mortality, hypotension, alkaline phosphatase, hemoglobin, lactate, tolerance to enteral nutrition and use of propofol. Imaging study revealed pancreatic alterations in two patients with high serum lipase.
  
  
  CONCLUSIONS
  Elevated lipase was commonly found in critical patients, it related with longer length of stay but was not accompanied by increased clinical severity or mortality. It was more frequent with parenteral nutrition. A minority of patients met the criteria of acute pancreatitis.
authors.affiliation: Internato Complementar de Gastrenterologia, Serviço de Gastrenterologia, Centro Hospitalar de Coimbra, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Ferreira
authors.affiliation: Serviço de Cuidados Intensivos, Centro Hospitalar de Coimbra.
authors.forename: Regina
authors.initials: R
authors.lastname: Coelho
authors.affiliation: Serviço de Cuidados Intensivos, Centro Hospitalar de Coimbra.
authors.forename: José
authors.initials: J
authors.lastname: Luzio
authors.affiliation: Serviço de Cuidados Intensivos, Centro Hospitalar de Coimbra.
authors.forename: Paula
authors.initials: P
authors.lastname: Coutinho