Propofol-induced hypertriglyceridemia in critically ill trauma patients requiring nutrition therapy: A descriptive cohort study.

BACKGROUND

This study aimed to assess the incidence and identify risk factors associated with the development of propofol-induced hypertriglyceridemia in critically ill trauma patients who required nutrition therapy.

METHODS

Adult patients (aged >17 years) admitted to the trauma intensive care unit who received propofol for >24 h and had a serum triglyceride concentration determination during the infusion were retrospectively evaluated. Hypertriglyceridemia was defined as a serum triglyceride concentration > 400 mg/dL. Potential risk factors for hypertriglyceridemia as well as linear and nonlinear correlative relationships between propofol-associated lipid injectable emulsion dose and serum triglyceride concentration were evaluated.

RESULTS

One hundred and ninety-five serum triglyceride determinations were obtained from 100 patients. Twenty-five patients (25%) developed hypertriglyceridemia. The greatest risk factor for hypertriglyceridemia was lipid injectable emulsion dose (0.48 [0.36, 0.64] vs 0.28 [0.20, 0.49] g/kg/day; P < 0.01). Those who exhibited hypertriglyceridemia had a higher C-reactive protein (P < 0.02), lower prealbumin (P = 0.001), higher serum creatinine (P < 0.04), and required more days of nutrition therapy (P < 0.03). The hypertriglyceridemia group exhibited a nonlinear concave lipid dose-serum triglyceride concentration response relationship (r = 0.731, P = 0.001) whereas those without hypertriglyceridemia had a flattened and variable linear relationship (r = 0.115, P = 0.34).

CONCLUSION

Hypertriglyceridemia is common during propofol therapy, reflective of lipid injectable emulsion dose, and is associated with greater inflammation, organ dysfunction, and severe critical illness requiring prolonged nutrition therapy.