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Dr. Sanketh J.
Dr. Vinay R.B
Dr. Chandan N
Dr. Arundhati R. Chitnis
Dr. Mohit A. Kalyankar


sepsis, lipid, prognosis



In intensive care units (ICUs), sepsis is the primary cause of death for patients who are critically unwell. Sepsis may cause changes in lipid metabolism. The aim of present study was to evaluate the serum lipid profile as a prognostic indicator for severity in sepsis.



The cross sectional study was conducted in the tertiary care hospital in Channapatna(SRI CHAMUNDESHWARI MEDICAL COLLEGE HOSPITAL AND RESEARCH INSTITUTE), India from the Department of General Medicine over a period of 5 months from November 2023 to March 2024 among 75 patients admitted to the ICU and medical ICU with sepsis and who survived for more than 48 hours. All the basic and lipid profile investigations were done and results were analyzed using SPSS version 25.0.



Out of 75 patients with severe sepsis 8% of patients died during the hospital stay and 92% patients survived and were discharged from the hospital. The mean age of patients in survived and non survived groups was between 60 and 70 years. The mean APACHE II score among survived patients was 27.12± 3.8 and in non survived was 24.31±2.8. The length of hospital stay was 5.8 days among survived and 5.5 days among non survived. The level of TG was significantly higher in non-survivors than in survivors. Cholesterol, HDL, and LDL levels did not show statistically significant differences between the two groups



Our study found that In patients with severe sepsis, lipoprotein concentrations fluctuate quickly. The HDL fractions show the pattern of an early, sharp drop in cholesterol and a delayed recovery in the LDL fractions. Hence some lipoproteins may be used as a clinical indicator to assess the outcome of patients with sepsis.

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1. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 sccm/esicm/accp/ats/sis international sepsis definitions conference. Intensive Care Medicine. 2003;29(4):530-38.
2. Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management. Bmj. 2016;353.
3. Carpentier YA, Scruel O. Changes in the concentration and composition of plasma lipoproteins during the acute phase response. Current Opinion in Clinical Nutrition & Metabolic Care. 2002;5(2):153-58.
4. Khovidhunkit W, Memon RA, Feingold KR, Grunfeld C. Infection and inflammationinduced proatherogenic changes of lipoproteins. Journal of Infectious Diseases. 2000;181(Supplement 3):S462-S72.
5. Abraham E: Why immunomodulatory therapies have not worked in sepsis. Intensive Care Med 1999; 25:556–566.
6. Hellman J, Warren HS: Antiendotoxin strategies. Infect Dis Clin N Am 1999; 13:371–386.
7. Feingold KR, Grunfeld C: Lipoproteins: Are they important components of host defense? Hepatology 1997; 26:1685–1686.
8. Flegel WA, Wolpl A, Mannel DN, et al: Inhibition of endotoxin-induced activation of human monocytes by human lipoproteins. Infect Immun 1989; 57:2237–2245.
9. Cavaillon JM, Fitting C, Haeffner Cavaillon N, et al: Cytokine response by monocytes and macrophages to free and lipoprotein-bound lipopolysaccharide. Infect Immun. 1990; 58: 2375–2382.
10. Emancipator K, Csako G, Elin RJ: In vitro inactivation of bacterial endotoxin by human lipoproteins and apolipoproteins. Infect Immun. 1992; 60:596–601.
11. Pajkrt D, Doran JE, Koster F, et al: Antiinflammatory effects of reconstituted highdensity lipoprotein during human endotoxemia. J Exp Med 1996; 184:1601–160.
12. Alvarez C, Ramos A: Lipids, lipoproteins, and apoproteins in serum during infection. Clin Chem 1986; 32:142–145.
13. Coetzee GA, Strachan AF, van der Westhuyzen DR, et al: Serum amyloid A-containing human high density lipoprotein 3. Density, size, and apolipoprotein composition. J Biol Chem 1986; 261:9644–9651.
14. Malle E, de Beer FC: Human serum amyloid A (SAA) protein: A prominent acute-phase reactant for clinical practice. Eur J Clin Invest 1996; 26:427–435.
15. Steel DM, Whitehead AS: The major acute phase reactants: C-reactive protein, serum amyloid P component and serum amyloid A protein. Immunol Today 1994; 15:81–88.
16. Moretti D, Ramirez MM, Settecase CJ, Bagilet DH, Quaglino MB. [Usefulness of procalcitonin upon admission to intensive care in the diagnosis and prognosis of sepsis]. Med Intensiva. 2013;37(3):156–62.
17. Paoli CJ, Reynolds MA, Sinha M, Gitlin M, Crouser E. Epidemiology and Costs of Sepsis in the United States-An Analysis Based on Timing of Diagnosis and Severity Level. Crit Care Med. 2018;46(12):1889–97.
18. Luthold S, Berneis K, Bady P, Muller B. Effects of infectious disease on plasma lipids and their diagnostic significance in critical illness. Eur J Clin Invest. 2007;37(7):573–9.
19. Yamano S, Shimizu K, Ogura H, Hirose T, Hamasaki T, Shimazu T, et al. Low total cholesterol and high total bilirubin are associated with prognosis in patients with prolonged sepsis. J Crit Care. 2016;31(1):36– 40.
20. Lee SH, Park MS, Park BH, Jung WJ, Lee IS, Kim SY, et al. Prognostic Implications of Serum Lipid Metabolism over Time during Sepsis. Biomed Res Int. 2015;2015:789298.
21. Barati M, Nazari MR, Talebi-Taher M, Farhadi N. Comparison of Lipid Profile in Septic and Non-Septic Patients. Iran J Clin Infect Dis. 2011;6(4):144–7.
22. Abdollahi O, Gohari. Ali, Nobakhtrad M, Golshahi H. Comparison of lipid profile changes in patients with severe sepsis and septic shock versus nonseptic patients admitted to the medical ICU of Semnan Kosar Hospital and its association with hospital mortality from 2013 to 2014. Scientific-Research Journal of Shahed University. 2016;120.
23. Tosheska Trajkovska K, Topuzovska S. High-density lipoprotein metabolism and reverse cholesterol transport: strategies for raising HDL cholesterol. Anatolian journal of cardiology. 2017;18(2):149–54.
24. Wang X, Nijman R, Camuzeaux S, Sands C, Jackson H, Kaforou M, et al. Plasma lipid profiles discriminate bacterial from viral infection in febrile children. Scientific Reports. 2019;9(1):17714.
25. Tanaka S, Labreuche J, Drumez E, Harrois A, Hamada S, Vigue B, et al. Low HDL levels in sepsis versus trauma patients in intensive care unit. Ann Intensive Care. 2017;7(1):60.
26. Esteban E, Ferrer R, Alsina L, Artigas A. Immunomodulation in sepsis: the role of endotoxin removal by polymyxin B-immobilized cartridge. Mediators of inflammation. 2013;2013:507539.
27. Moini L, Mozafari A, Peyroshabani B. Evaluation of the Relationship between Serum Lipid Level (Total Cholesterol, LDL, HDL) and APACHE IV Score in ICU Patients. HBI_Journals. 2014;17(2):64–72.
28. Bedi P, Chalmers JD, Graham C, Clarke A, Donaldson S, Doherty C, et al. A Randomized Controlled Trial of Atorvastatin in Patients With Bronchiectasis Infected With Pseudomonas Aeruginosa: A Proof of Concept Study. Chest. 2017;152(2):368–7