title: Lipid metabolism in critical illness.
abstract: OBJECTIVE
  This article describes recent findings regarding lipid metabolism in critical illness as well as in lipid therapy.
  
  
  RESULTS
  In critical illness, in the presence of a decrease in lipid absorption, adipose tissue lipolysis raises triglyceride levels. High-density lipoprotein and low-density lipoprotein are decreased because of impairment of lecithin-cholesterol acyltransferase, mainly in sepsis. In septic patients, lipid profile may be a predictor of survival. Nonsurvivors have lower levels of high-density lipoprotein and low-density lipoprotein. In metabolomic studies, most of the changes from baseline in septic patients were related to lipid metabolism. Lysophosphatidylcholine was also significantly lower in nonsurviving septic patients.
  
  
  CONCLUSIONS
  Lipid profile results are too often neglected by the clinician despite increasing knowledge in the modifications related to septic state as well as the importance of these values in the prognosis of the critically ill. Lipid administration (enterally or parenterally) should be guided by better knowledge of the lipid metabolism of the patient.
authors.affiliation: aFelsenstein Medical Research Center, Metabolic Laboratory bNursing Department, Steyer School of Health Professions cGeneral intensive Care Department, Institute for Nutrition Research, Rabin Medical Center, Sackler School of Medicine, Beilinson Hospital, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Pnina
authors.initials: P
authors.lastname: Green
authors.forename: Miriam
authors.initials: M
authors.lastname: Theilla
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000818:Animals; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D016638:Critical Illness; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D006801:Humans; D050356:Lipid Metabolism / Q000502:physiology*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000378:metabolism* / Q000628:therapy; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid