Profile of serum cholinesterase in systemic sepsis syndrome (septic shock) in intensive care unit patients.

Serum cholinesterase catalytic concentrations were estimated in 26 patients diagnosed as having systemic sepsis syndrome (septic shock) in the Intensive Care Unit (12 were admitted with the diagnosis of systemic sepsis syndrome while 14 patients developed the syndrome while in the unit) and in 66 normal, healthy subjects. The assay was performed for 7 consecutive days in the patient group. There was a very significant decrease in the level of cholinesterase in the patient group from the onset of the study as compared to the control group (P < 0.00001). This decrease remained during the course of the seven day study period, indicating hepatic dysfunction early in the diagnosis. When compared to other conventional liver function tests, serum cholinesterase seems to change earlier on in the diagnosis. Prothrombin time showed a pattern of change similar to that of serum cholinesterase. There was a significant relationship between the catalytic concentration of serum cholinesterase and the outcome of the systemic sepsis syndrome, the level being significantly lower in patients who died in comparison to those who lived. It seems that serum cholinesterase is a sensitive indicator of hepatic dysfunction in the systemic sepsis syndrome.