Prospective flow cytometry analysis of leucocyte subsets in critically ill patients who develop sepsis: a pilot study.
Purpose: Sepsis in critically ill patients with injury bears a high morbidity and mortality. Extensive phenotypic monitoring of leucocyte subsets in critically ill patients at ICU admission and during sepsis development is still scarce. The main objective of this study was to identify early changes...
| Publicado en: | Infection Vol. 51; no. 5; pp. 1305 - 1318 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=172441946&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 172441946 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Oct2023 vid: 51 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 172441946 161474698 172441946 172441946 10.1007/s15010-023-01983-3 172441946 ppf: 1305 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Prospective flow cytometry analysis of leucocyte subsets in critically ill patients who develop sepsis: a pilot study. aug: au: Layios, Nathalie Gosset, Christian Maes, Nathalie Delierneux, Céline Hego, Alexandre Huart, Justine Lecut, Christelle Damas, Pierre Oury, Cécile Gothot, André affil: https://ror.org/00afp2z80 Department of Intensive Care, University Hospital of Liege, Domaine universitaire du Sart-Tilman, 4000, Liege, Belgium sug: subj: Biological Markers Blood Leukocytes Flow Cytometry Critically Ill Patients Sepsis Diagnosis Sepsis Risk Factors Shock, Septic Risk Factors Risk Assessment Phenotype Wounds and Injuries Cross Infection Risk Factors Cross Infection Epidemiology Sepsis Epidemiology Human Pilot Studies Descriptive Statistics Odds Ratio Confidence Intervals Monocytes Scales Logistic Regression Prospective Studies Nonexperimental Studies Belgium Blood Specimen Collection Autoanalysis Immunophenotyping Cytokines Blood Plasma Tumor Necrosis Factor Blood Interleukins Blood Data Analysis Software Analysis of Variance Kruskal-Wallis Test Chi Square Test Fisher's Exact Test Multiple Logistic Regression ROC Curve Male Female Middle Age Aged Aged, 80 and Over Sepsis Mortality Length of Stay Inpatients Intensive Care Units Tertiary Health Care Surgery, Elective Cardiac Surgery Respiration, Artificial Step-Wise Multiple Regression HLA Antigens Blood C-Reactive Protein Blood Sepsis Blood T Lymphocytes B Lymphocytes Neutrophils Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: Sepsis in critically ill patients with injury bears a high morbidity and mortality. Extensive phenotypic monitoring of leucocyte subsets in critically ill patients at ICU admission and during sepsis development is still scarce. The main objective of this study was to identify early changes in leukocyte phenotype which would correlate with later development of sepsis. Methods: Patients who were admitted in a tertiary ICU for organ support after severe injury (elective cardiac surgery, trauma, necessity of prolonged ventilation or stroke) were sampled on admission (T1) and 48–72 h later (T2) for phenotyping of leukocyte subsets by flow cytometry and cytokines measurements. Those who developed secondary sepsis or septic shock were sampled again on the day of sepsis diagnosis (Tx). Results: Ninety-nine patients were included in the final analysis. Nineteen (19.2%) patients developed secondary sepsis or septic shock. They presented significantly higher absolute monocyte counts and CRP at T1 compared to non-septic patients (1030/µl versus 550/µl, p = 0.013 and 5.1 mg/ml versus 2.5 mg/ml, p = 0.046, respectively). They also presented elevated levels of monocytes with low expression of L-selectin (CD62Lneg monocytes) (OR[95%CI] 4.5 (1.4–14.5), p = 0.01) and higher SOFA score (p < 0.0001) at T1 and low mHLA-DR at T2 (OR[95%CI] 0.003 (0.00–0.17), p = 0.049). Stepwise logistic regression analysis showed that both monocyte markers and high SOFA score (> 8) were independently associated with nosocomial sepsis occurrence. No other leucocyte count or surface marker nor any cytokine measurement correlated with sepsis occurrence. Conclusion: Monocyte counts and change of phenotype are associated with secondary sepsis occurrence in critically ill patients with injury. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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