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

Abstract 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.