Background: Sepsis is a devastating disease and accounts for high mortality and morbidity in patients treated in the intensive care unit (ICU). Lipoproteins, especially the high-density lipoprotein (HDL) particles, play an important role in the innate immune defense. In addition, proton nuclear magnetic resonance (1H NMR) spectroscopy is an emerging technique for targeted and untargeted analyses of metabolites. Aim: To investigate quantitative and qualitative changes of lipoproteins during sepsis, investigate correlations with organ dysfunction and associations with ICU- and 28-day mortality. Methods: Adult patients with sepsis and septic shock, as well as ICU controls without sepsis or bacteremia were enrolled at the ICU of the Department of Internal Medicine at the Medical University of Graz. Sepsis was defined according to the current sepsis-3 criteria with a suspected infection by the treating physician and an increase in the sequential organ failure assessment (SOFA) score by ≥2 points. Septic shock was defined as patients with sepsis, with the need of vasopressor therapy to maintain a mean arterial pressure ≥65mmHg despite adequate fluid resuscitation and/or absence of hypovolemia; and a lactate level of >2 mmol/L. Quantitative assessments of lipoproteins were performed on routine laboratory machines. For qualitative lipoprotein measurements, both the arylesterase activity of the HDL associated paraoxonase (AEA) and cholesterol efflux capacity (CEC) were performed with ApoB-depleted sera. In addition, targeted and untargeted 1H NMR metabolomics were studied. Results: Fifty-three ICU patients with sepsis and 25 ICU controls without sepsis or bacteremia were prospectively enrolled. HDL-C
Lipoproteins and metabolites in sepsis and septic shock in the intensive care unit
Reisinger, A. C. (Autor/-in). 2022
Studienabschlussarbeit: Dissertation