Wednesday, February 13, 2013

[49] What is the impact of high triglyceride levels in severely burned pediatric patients?

High triglycerides impact in pediatric burns
[Kraft, JCEM, 2013, burn, triglycerides, hepatomegaly]

- Pediatric severe (30-70% BSA) burn patients stratified: normal n=127, elevated FFA 46, and elevated TG 63
- TG levels increased in all 3 groups over time
- High TG spent longest time in ICU, had highest multiorgan failure, and mortality compared to normal
- Normal and high TG required more insulin between d8 and 23
- Hepatic acute phase reactants significantly increased in TG group compared to normal
- Liver size increased in Tg group compared to normal and FFA patients

 2013 Jan;98(1):314-21. doi: 10.1210/jc.2012-2599. Epub 2012 Nov 12.

Association of postburn Fatty acids and triglycerides with clinical outcome in severely burned children.


F.A.C.S., F.C.C.M., F.R.C.S.(C.),Sunnybrook Health Sciences Centre, Department of Surgery, Division of Plastic Surgery, University of Toronto, Sunnybrook Research Institute, Room D704, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.


Context: Free fatty acids (FFAs) and triglycerides (TGs) are altered postburn, but whether these alterations are associated with postburn outcomes is not clear. Objective: The aim of the present study was to analyze lipid metabolic profiles in pediatric burn patients and to correlate these profiles with patient outcomes and hospital courses. Design and Setting: We conducted a prospective cohort study at an academic pediatric hospital burn center. Patients: Our study included 219 pediatric burn patients. Main Outcome Measures: Patients were stratified according to their plasma TG and FFA levels. Main patient outcomes, such as postburn morbidity and mortality, and clinical metabolic markers were analyzed. Results: All groups were similar in demographics and injury characteristics. Patients with elevated TGs had significantly worse clinical outcomes associated with increased acute-phase protein synthesis indicating augmented inflammation and hypermetabolism, whereas increased FFAs did not seem to profoundly alter postburn outcomes. Conclusions: Elevated TGs, but not FFAs, postburn are associated with worsened organ function and clinical outcomes.

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