2014, Number 2
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Med Crit 2014; 28 (2)
Pattern of lymphocyte response to severe sepsis and mortality in critically ill patients
Muñoz RMR, Chávez PCE, Aguilar RLÁ, Campos DJA, Sánchez NVM
Language: Spanish
References: 11
Page: 91-94
PDF size: 140.57 Kb.
ABSTRACT
Background: Sepsis-induced immunosuppresion is a severe mechanism ocurring not only systematically but also locally. Alterations include severe lymphopenia, decreased T-cell proliferation and cytokine production.
Material and methods: A retrospective study was performed during a 6 months period. Data were collected from the records of all consecutive adult patients with severe sepsis who stayed for more than seven days in Intensive Care Unit and had at least two complete blood counts. We divided the patients by lymphocyte count (< 800 and > 800
9/L). Lymphopenia was defined as any value below 0.8 x 10
9/L.
Results: 38 patients were included. Mean age was 60.45 ± 19.45 years, (68.4%) were males. Admission diagnosis: medical 52.6%, surgical 18.4% and trauma 28.9%. Mean APACHE II and SOFA score were 17 ± 4.75 and 6 ± 2.8 respectively. The mean of mechanical ventilation was 7 ± 6.7 days. The length of stay in Intensive Care Unit was 12.5 days ± 8.15. Seven patients (18.4%) died during hospitalization. Logistic regression analysis showed that admission count of lymphocytes had greater association with mortality p= 0.073.
Conclusions: Persistent lymphopenia is associated with mortality without statistically significance. A failure to normalize lymphopenia is associated with mortality. Preventing lymphocyte dysfunction, specifically preventing its apoptosis following sepsis has been shown to improve mortality.
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