| Summary: | Background Bioactive lipid mediators play a crucial role during infection. Previously, we showed the expression level of FAAH mRNA in septic patients was lower than in healthy controls. Case Presentation Four patients with a Sequential Organ Failure Assessment (SOFA) score of <7 recovered from sepsis. One patient with SOFA score of 12 on day 7 died on day 21. In the fatal case, eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, and linoleic acid‐derived lipid mediators, including 9‐hydroxyoctadecadienoic acid (9‐HODE), 13‐HODE, 9,10‐dihydroxy‐12‐octadecenoic acid (9,10‐DiHOME), and 12,13‐DiHOME, were elevated on day 1. Increase in anti‐inflammatory prostaglandin E1 ethanolamide together with persistently lower transcription level of FAAH mRNA was detected on day 7 in the fatal case. Conclusion Lipidomic analysis on day 1 revealed elevated linoleic acid metabolites, whereas on day 7, elevated prostaglandin E1 ethanolamide and low level of FAAH mRNA transcription were observed in the fatal case of sepsis.
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