Correlation between Acute Physiology and Chronic Health Evaluation (APACHE) III score and immunological parameters in critically ill patients with sepsis
| Autor: | Lyle L. Moldawer, H. S. A. Oldenburg, S. Coyle, R. Trousdale, Stephen F. Lowry, M. A. Rogy |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Lipopolysaccharide Critical Care medicine.medical_treatment Physiology Stimulation Enzyme-Linked Immunosorbent Assay Peripheral blood mononuclear cell Sepsis Correlation chemistry.chemical_compound Downregulation and upregulation medicine Humans APACHE Aged Aged 80 and over business.industry Interleukin Middle Aged medicine.disease Shock Septic Survival Rate Cytokine chemistry Chronic Disease Leukocytes Mononuclear Cytokines Surgery Female business |
| Zdroj: | The British journal of surgery. 83(3) |
| ISSN: | 0007-1323 |
| Popis: | A relationship between physiological parameters of severe sepsis and immunological function has not been established. In ten severely ill patients with sepsis physiological risk was assessed by the Acute Physiology and Chronic Health Evaluation (APACHE) III score, while one component of immunological function was evaluated using peripheral blood mononuclear cell (PBMC) cytokine production after stimulation with lipopolysaccharide (LPS) in vitro. Five of the ten patients died. Mean(s.e.m.) APACHE III scores at admission were not significantly different between survivors and non-survivors (82(13) versus 95(13)) but after 72 h they were lower in survivors (51(13) versus 111(15), P < 0·05). Downregulation of cytokine production by PBMC on LPS stimulation was a transient event in survivors. Survivors had a three-fold increase in tumour necrosis factor α bioactivity within 72 h, but there was no increase in non-survivors. A similar pattern was demonstrated for interleukin (IL) 1β (P < 0·05 between survivors and non-survivors) and IL-6 (P = 0·06) immunoactivity. Physiological as well as immunological parameters in critically ill patients with sepsis independently predicted hospital survival (r2 = 0·2). These data demonstrate a relationship between the pattern of cytokine production in vitro and survival. |
| Databáze: | OpenAIRE |
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