[Changes in the cell-mediated immune system in post-traumatic sepsis]. / Alterazioni del sistema immunitario cellulo-mediato nella sepsi post-traumatica.
Minerva Anestesiol
; 60(3): 87-94, 1994 Mar.
Article
em It
| MEDLINE
| ID: mdl-8090311
ABSTRACT
OBJECTIVE:
We studied the alterations of cell-mediated immunity (CMI) in polytrauma patients and its relation with sepsis.DESIGN:
a prospective study.SETTING:
ICU, Ospedale Maggiore, Bologna (Italy). PATIENTS We included in the study 42 patients with at least two of following criteria 1) Trauma Score < or = 12; 2) Abbreviated Injury Score > or = 4; 3) Arterial Pressure on admission < or = 80 mmHg; 4) Injury Severity Score > or = 16. CMI examinations were carried out at three different post-traumatic times (T0-T2). Seventeen patients developed a sepsis within the first eight days from admission.RESULTS:
Sepsis caused a temporary impairment in some lymphocyte subsets at T2. The patients who developed sepsis showed a significant subset percentage difference for CD3, CD3 activated (p < 0.05) and for interleukin-2 receptor (IL-2R) (p < 0.01) in comparison with the non septic group. At T2, the seven septic patients who died, showed a marked depression of IL-2 values (0.37 +/- 0.12 UI/ml) in comparison with the values of septic patients who survived (0.66 +/- 0.25 UI/ml; p < 0.01) and with the group of non septic patients (0.83 +/- 0.5 UI/ml; p < 0.001). Septic patients who had a IL-2 value of 0.45 or lower had a mortality of 75%. IL-2 values showed a specificity of 89% and a sensibility of 75% in predicting mortality in septic trauma patients.CONCLUSION:
We believe that in polytrauma patients IL-2 values monitoring could be a reliable index of the disfunction of CMI and that IL-2R sieric levels could be a diagnostic marker of impending sepsis.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismo Múltiplo
/
Imunidade Celular
/
Infecções
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
/
Middle aged
Idioma:
It
Revista:
Minerva Anestesiol
Ano de publicação:
1994
Tipo de documento:
Article