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Metabolites. 2018 Oct 6;8(4). pii: E62. doi: 10.3390/metabo8040062.

Microdialysis-Assessed Adipose Tissue Metabolism, Circulating Cytokines and Outcome in Critical Illness.

Author information

1
Endocrine Unit, Elena Venizelou Hospital, GR-11521 Athens, Greece. iiliasmd@yahoo.com.
2
Second Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, GR-12462 Athens, Greece. sofapol@yahoo.gr.
3
Department of Critical Care Medicine, North Middlesex Hospital, London N18 1QX, UK. Nikitas.nikitas@outlook.com.
4
Second Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, GR-12462 Athens, Greece. Mariatheodor10@gmail.com.
5
First Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Medical School, GR-10552 Athens, Greece. alvass75@gmail.com.
6
First Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Medical School, GR-10552 Athens, Greece. akotanid@med.uoa.gr.
7
First Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Medical School, GR-10552 Athens, Greece. idimo@otenet.gr.

Abstract

Microdialysis (MD) can provide continuous information about tissue composition. To assess in critically ill patients adipose tissue metabolic patterns, the relationships between metabolic patterns and blood cytokine concentration associations of adipose tissue energy metabolism and clinical outcome we studied 203 mechanically ventilated general intensive care unit (ICU) patients. Upon ICU admission an MD catheter was inserted into the subcutaneous adipose tissue of the upper thigh to measure lactate (L), glucose, pyruvate (P), and glycerol. Serum concentrations of IL-10, IL-6, IL-8, and TNF-α were determined within 48 h from ICU admission. Mitochondrial dysfunction was defined as L/P ratio >30 and pyruvate ≥70 μmol/L, ischemia as L/P ratio >30 and pyruvate <70 μmol/L and no ischemia/no mitochondrial dysfunction (i.e. aerobic metabolism) was as L/P ratio ≤30. Metabolism was aerobic in 74% of patients. In 13% of patients there was biochemical evidence of ischemia and in 13% of patients of mitochondrial dysfunction. Mitochondrial dysfunction was associated with poor outcome. In conclusion, MD showed that about two thirds of critically ill patients have normal aerobic adipose tissue metabolism. Mitochondrial dysfunction was not common but was associated with poor outcome. Identifying subgroups of critically ill patients is crucial as different treatment strategies may improve survival.

KEYWORDS:

intensive care unit; lactate clearance; microdialysis; tissue ischemia

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