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The Relationship between the Plasma Triglyceride Concentration and the Severity of Acute Respiratory Distress Syndrome

https://doi.org/10.15360/1813-9779-2012-1-22

Abstract

Triglycerides (TG) may be involved in the pathogenesis of critical impairments. Objective: to study the relationship between the plasma concentration of TG, the outcome of the disease, and the markers of its severity in intensive care unit patients with early-stage acute respiratory distress syndrome (ARDS). Subjects and methods. The prospective study included 18 patients with acute lung injury (ALI), who needed respiratory support. For further analysis, all the patients were divided into groups with TG < 1.00 mmol/l (TGlow; n=7) and >1.00 mmol/l (TGhigh; n=11). Results. A negative correlation was found between plasma TG concentration and oxygenation index (PaO2/FiO2). In the TG^jgh group, extravas-cular lung water index was significantly higher and cardiac index was lower than those in the TGlow group. Among the deceased patients, there was a 1.03 mmol/l reduction in TG concentration by day 4 of the study whereas in the survivors, TG concentration increased by an average of 0.15 mmol/l (p=0.02). Conclusion. In the patients with ALI, the plasma concentration of TG is related to oxygenation impairments and the degree of pulmonary edema, as well as with the outcome of the disease. Key words: triglycerides, acute lung injury, extravascular lung water index, pulmonary edema.

References

1. Мороз В. В., Молчанова Л. Н., Щербакова Л. Н. и соавт.

2. Щербакова Л. Н., Молчанова Л. В., Малахова С. В.Дислипидемия при критических состояниях различной этиологии. Общая реаниматология 2008; IV (1): 36—40.

3. Мороз В. В., Молчанова Л. В., Муравьёва М. Ю. и соавт.Нарушения липидного обмена после тяжёлой механической травмы. Общая реаниматология 2006; II (5—6): 40—4

4. Bertrand Y.Oxygen-free radicals and lipid peroxidation in adult respiratory distress syndrome. Intensive Care Med. 1985; 11 (2): 56—60.

5. Kruger P. S.Forget glucose: what about lipids in critical illness? Crit. Care Resusc. 2009; 11 (4): 305—309.

6. Малкова О. Г., Лейдерман И. Н., Левит А. Л.Изменение показателей липидного обмена у больных с тяжелым сепсисом. Анестезиология и реаниматология 2009; 2: 23—2

7. Левит А. Л., Лейдерман И. Н., Малкова О. Г., Нитенко С. П.Расстройства липидного обмена при тяжелом сепсисе: клиническое значение и новые методы коррекции. Общая реаниматология 2009; V (4): 66—74.

8. Kunz F., Hortnagl H., Kroesen G., Rumpl E.Plasma lipids, coagulation factors, and fibrin formation after severe multiple trauma, and in adult respiratory distress syndrome. J. Trauma 1978; 18 (2): 115-120.

9. Чурин Б. В., Асташов В. В., Старкова Е. В., Чуканов А. С.Роль легких в утилизации триглицеридов из плазмы крови после приема жира в норме и при экспериментальном ожирении. Эксперим. клин. гастроэнтерология 2010; 4: 70—72.

10. Rosenkranz S. K., TownsendD. K., Steffens S. E., Harms C. A.Effects of a high-fat meal on pulmonary function in healthy subjects. Eur. J. Appl. Physiol. 2010; 109 (3): 499—506.

11. Lekka M. E., Liokatis S., Nathanail C. et al.The impact of intravenous fat emulsion administration in acute lung injury. Am. J. Respir. Crit. Care Med. 2004; 169 (5): 638—644.

12. Kuzkov V. V., Suborov E. V., Kirov M. Y. et al.Radiographic lung density assessed by computed tomography is associated with extravascular lung water content. Acta Anaesthesiol. Scand. 2010; 54 (8): 1018—1026.

13. Bernard G., Artigas A., Brigham K. et al.The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am. J. Respir. Crit. Care Med. 1994; 149 (3 Pt 1): 818—824.

14. МорозВ. В., ГолубевА. М., МарченковЮ. В. исоавт.Морфологические признаки острого повреждения легких различной этиологии (экспериментальное исследование). Общая реаниматология 2010; VI (3): 29—34.

15. Мороз В. В., Голубев А. М.Принципы диагностики ранних проявлений острого повреждения лёгких. Общая реаниматология 2006; II (4): 5—7.

16. Мороз В. В., Голубев А. М.Классификация острого респираторного дистресс-синдрома. Общая реаниматология 2007; III (5—6): 7—9.

17. Kuzkov V. V., Kirov M. Y., Sovershaev M. A. et al.Extravascular lung water determined with single transpulmonary thermodilution correlates with the severity of sepsis-induced acute lung injury. Crit. Care Med. 2006; 34 (6): 1647—1653.

18. Craig T. R., Duffy M. J., Shyamsundar M. et al.Extravascular lung water indexed to predicted body weight is a novel predictor of intensive care unit mortality in patients with acute lung injury. Crit. Care Med. 2010; 38 (1): 114—120.

19. Kunz F., Hortnagl H., Kroesen G., Rumpl E.Plasma lipids, coagulation factors, and fibrin formation after severe multiple trauma, and in adult respiratory distress syndrome. J. Trauma 1978; 18 (2): 115—120.

20. O NealH. R., Koyama T., Koehler E. A. et al.Prehospital statin and aspirin use and the prevalence of severe sepsis and acute lung injury/acute respiratory distress syndrome. Crit. Care Med. 2011; 39 (6): 1343—1350.

21. Craig T. R., Duffy M. J., Shyamsundar M. et al.A randomized clinical trial of hydroxymethylglutaryl-coenzyme a reductase inhibition for acute lung injury (The HARP Study). Am. J. Respir. Crit. Care Med. 2011; 183 (5): 620—626.

22. Kannel W. B., Vasan R. S.Triglycerides as vascular risk factors: new epi-demiologic insights. Curr. Opin. Cardiol. 2009; 24 (4): 345—350.

23. Chung F. T., Lin S. M., Lin S. Y., Lin H. C.Impact of extravascular lung water index on outcomes of severe sepsis patients in a medical intensive care unit. Respir. Med. 2008; 102 (7): 956—961.

24. Davey-Quinn A., Gedney J. A., Whiteley S. M., Bellamy M. C.Extravascular lung water and acute respiratory distress syndrome- oxy-genation and outcome. Anaesth. Intensive Care 1999; 27 (4): 357—362.

25. Mesotten D., Swinnen J. V., Vanderhoydonc F. et al.Contribution of circulating lipids to the improved outcome of critical illness by glycemic control with intensive insulin therapy. J. Clin. Endocrinol. Metab. 2004; 89 (1): 219—226.


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For citations:


Kuzkov V.V., Fot E.V., Smetkin A.A., Komarov S.A., Kirov M.Yu. The Relationship between the Plasma Triglyceride Concentration and the Severity of Acute Respiratory Distress Syndrome . General Reanimatology. 2012;8(1):22. (In Russ.) https://doi.org/10.15360/1813-9779-2012-1-22

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