Influence of the serum cholesterol in the clinical evolution of burned patients
Abstract
Introduction: The low concentrations of lipids and the lipoproteins in the burnt patients have been associated with a bad forecast, with a high morbility and mortality.
Objective: To determine the influence of serum cholesterol un the clinical evolution of burned patients.
Methods: An observational, descriptive study of longitudinal cut was carried out to determine the influence of the serum cholesterol in the clinical evolution of patient burnings in the service of Plastic Surgery and Caumatology of the Hospital Universitary Manuel Ascunce Domenech of the city Camagüey in the period understood since October of the 2019 to September of the 2020. 16 patients were studied, evaluating the severity rate, the changes in the levels of cholesterol, as well as its relation with the sepsis, evolutionary tendency of cholesterol and state to the expenditure of the patients.
Results: Between the seven to fourteen days of evolution seventy five percent of the patients had low numbers of cholesterol with a predominance in the critic patients. Of the twelve patients that developed sepsis, more of the sixty eight percent had low numbers of cholesterol; of them five patients were classified as critics so there was a tendency to a deterioration relating to the severity rate. Thirteen of the patients of this series exited live.
Conclusions: The serious burns occur with alterations in the metabolism of the lipids. A significant finding was that the patients that developed infection had with low levels of cholesterol. The hypocholesterolaemia was associated to a worse forecast of these patients.
DeCS: CHOLESTEROL; PATIENTS; BURNS; CLINICAL EVOLUTION; METABOLISM.
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References
1. Miquet Romero LM, Landaverde Hernández LO, Rodríguez Garcell RA, Escobar Vega H. Hipocolesterolemia en el paciente quemado. Acta médica [Internet]. 2016 [citado 19 Oct 2020];17(2):[aprox. 11 p.]. Disponible en: https://www.medigraphic.com/pdfs/actamedica/acm-2016/acm162m.pdf
2. Smolle C, Cambiaso-Daniel J, Forbes AA, Wurzer P, Hundeshagen G, Branski LK, et al. Recent Trends in Burn Epidemiology Worldwide: A Systematic Review. Burns [Internet]. 2017 Mar [citado 19 Oct 2020];43(2):[aprox. 9 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5616188/.
3. Carrillo Esper R, Núñez Monroy FN. Dislipidemia en quemaduras graves. Rev Asoc Mex Med Crit Ter Int [Internet]. Mar-Abr 1999 [citado 25 Nov 2020];13(2):[aprox. 8 p.]. Disponible en: https://www.medigraphic.com/pdfs/medcri/ti-1999/ti992c.pdf
4. Moreira E, Burghi G, Manzanares W. Metabolismo y terapia nutricional en el paciente quemado crítico: una revisión actualizada. Med Intensiva [Internet]. Jun-Jul 2018 [citado 25 Nov 2020];42(5):[aprox. 11 p.]. Disponible en: https://www.medintensiva.org/es-metabolismo-terapia-nutricional-el-paciente-articulo-S0210569117302231
5. Miquet Romero LM, Escobar Vega H, Chávez Mondragón MA, Castañeda Prada A, Gutiérrez Rojas A, Posada Ruiz DA. Colesterol total sérico en la evolución del paciente quemado. Acta médica [Internet]. 2020 [citado 20 Dic 2020];21(3):[aprox. 15 p.]. Disponible en: www.revactamedica.sld.cu/index.php/act/article/download/75/pdf
6. Papadópulos Canales AA, Gutiérrez Salgado E, Duffy Verdura BE, Fernández Sobrino G, Portal Celhay C, Pérez Penilla F. Hipocolesterolemia y evolución clínica en pacientes quemados graves. Cir Plast [Internet]. Sep-Dic 2005 [citado 25 Nov 2020];15(3):[aprox. 5 p.]. Disponible en: https://www.medigraphic.com/pdfs/cplast/cp-2005/cp053c.pdf
7. Torres Amaro A, Jiménez García R. Sobre el apoyo nutricional del paciente quemado. Rev Cubana Aliment Nutr [Internet]. Jul-Dic 2016 [citado 25 Nov 2020];26(2):[aprox. 28 p.]. Disponible en: https://www.medigraphic.com/pdfs/revcubalnut/can-2016/can162k.pdf
8. Ogunbileje JO, Porter C, Herndon DN, Chao T, Abdelrahman DR, Papadimitriou A, et al. Hypermetabolism and hypercatabolism of skeletal muscle accompany mitochondrial stress following severe burn trauma. Am J Physiol Endocrinol Metab [Internet]. 2016 Ago [citado 25 Nov 2020];311(2):E436-48. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27382037/.
9. Gacto-Sánchez P. Surgical treatment and management of the severely burn patient: Review and update. Med Intensiva. 2017 Ago-Sep;41(6):356-364. doi: 10.1016/j.medin.2017.02.008.
10. Wiegering Cecchi GM, Rios Hidalgo E, Cordova Orrillo JV, Ludeña Muñoz JR, Medina CA. Características clínica epidemiológica y patrones de prescripción para quemaduras en tres hospitales de Lima, Perú. Rev perú med exp salud publica [Internet]. Ene-Mar 2019 [citado 25 Nov 2020];36(1). Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1726-46342019000100010
11. Collado Hernández CM, Pérez Núñez V, Lorente Gil SR, Pérez Suárez FA. Caracterización clínica epidemiológica de las quemaduras del adulto mayor ingresado en el Hospital Celia Sánchez. Correo cient méd [Internet]. Jul-Sep 2015 [citado 19 Dic 2020];19(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1560-43812015000300002
12. Chiarla C, Giovannini I, Giuliante F, Zadak Z, Vellone M, Ardito F, et al. Severe hypocholesterolemia in surgical patients, sepsis, and critical illness. J Crit Care. 2010 Jun;25(2):361.e7-.e12. doi: 10.1016/j.jcrc.2009.08.006.
13. Rodríguez Aboytes AS. Retos del Tratamiento Nutricio en el Paciente Quemado en Estado Crítico [tesis maestría]. México, D. F: Instituto Nacional de Salud Pública; Ago 2015 [citado 25 Nov 2020]. Disponible en: https://catalogoinsp.mx/files/tes/054691.pdf
14. Sudenis T, Hall K, Cartotto R. Enteral nutrition: what the dietitian prescribes is not what the burn patient gets! J Burn Care Res. 2015 Mar-Abr;36(2):297–305. doi: 10.1097/BCR.0000000000000069.
15. Marín Palma D, Andrea Taborda N, Urcuqui Inchima S, Hernández JC. Inflamación y respuesta inmune innata: participación de las lipoproteínas de alta densidad. Iatreia [Internet]. Oct-Dic 2017 [citado 25 Nov 2020];30(4):[aprox. 13 p.]. Disponible en: http://www.scielo.org.co/pdf/iat/v30n4/0121-0793-iat-30-04-00423.pdf
16. Contreras Duarte S, Varas P, Awad F, Busso D, Rigotti A. Papel protector de las lipoproteínas de alta densidad en sepsis: aspectos básicos e implicaciones clínicas. Rev chilena infectol [Internet]. Feb 2014 [citado 30 Nov 2020];31(1). Disponible en: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182014000100005
17. Carrión D. Hipocolesterolemia: más allá de un valor de laboratorio. Rev ANACEM [Internet]. 2018 [citado 30 Nov 2020];11(2):4-5. Disponible en: https://docs.bvsalud.org/biblioref/2021/07/1123109/revista-anacem-112-9-10.pdf
18. Godinez Vidal AR, López Betancourt CE, Gutiérrez Uvalle GE, González Catalayud M, Zavala Castillo JC, Gracida Mancilla NI. Evaluación del nivel de lipoproteína de alta densidad como predictor de gravedad en la sepsis abdominal. Cir Cir [Internet]. 2020 [citado 25 Nov 2020];88(1):[aprox. 6 p.]. Disponible en: http://www.cirugiaycirujanos.com/files/circir_20_88_1_001-006.pdf
19. Tanaka S, Lobreuche J, Drumez E, Harrois A, Hamada S, Vigué B, et al. Low HDL levels in sepsis versus trauma patients in care unit. Ann Intensiv Care [Internet]. 2017 [citado 25 Nov 2020];7:60. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461227/.
20. Gadann BK, Narayanan M. Study of serum HDL-Cholesterol levels in sepsis patients and its prognostic significance. Int J Adv Med [Internet]. 2019 Abr [citado 30 Nov 2020];6(2):[aprox. 6 p.]. Disponible en: https://www.ijmedicine.com/index.php/ijam/article/view/1607/1167
21. Jones TK, Wong HR, Meyer NJ. HDL Cholesterol: A Pathogen Lipid Sink for Sepsis? Am J Respir Crit Care Med [Internet]. 2019 Abr [citado 20 Dic 2020];199(7):[aprox. 3 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6444663/.

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