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[Changes in the cell-mediated immune system in post-traumatic sepsis]

M Vinelli1, F Ferrari, V Zanni

  • 1I Servizio di Anestesia e Rianimazione, Ospedale Maggiore C. A. Pizzardi, USL n. 27, Bologna.

Minerva Anestesiologica
|March 1, 1994
PubMed
Summary

In polytrauma patients, sepsis temporarily impairs cell-mediated immunity (CMI). Monitoring interleukin-2 (IL-2) levels can predict mortality and identify sepsis risk in trauma patients.

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Area of Science:

  • Immunology
  • Trauma critical care

Background:

  • Polytrauma patients often experience immune system dysregulation.
  • Sepsis is a major complication in polytrauma, leading to increased morbidity and mortality.
  • Understanding the impact of trauma on cell-mediated immunity (CMI) is crucial for patient outcomes.

Purpose of the Study:

  • To investigate alterations in CMI in polytrauma patients.
  • To determine the relationship between CMI changes and the development of sepsis.
  • To identify potential biomarkers for sepsis and mortality prediction in trauma patients.

Main Methods:

  • A prospective study was conducted in an intensive care unit (ICU).
  • 42 polytrauma patients meeting specific trauma severity criteria were enrolled.
  • Cell-mediated immunity (CMI) was assessed at three time points post-trauma; 17 patients developed sepsis.

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Main Results:

  • Sepsis was associated with temporary impairment of specific lymphocyte subsets (CD3, CD3 activated) and elevated interleukin-2 receptor (IL-2R) levels.
  • Septic patients who died showed significantly lower interleukin-2 (IL-2) levels compared to survivors and non-septic patients.
  • IL-2 levels below 0.45 UI/ml predicted a 75% mortality rate in septic trauma patients, with 89% specificity and 75% sensitivity.

Conclusions:

  • Monitoring interleukin-2 (IL-2) values in polytrauma patients can serve as a reliable indicator of CMI dysfunction.
  • Serum IL-2 receptor (IL-2R) levels may act as a diagnostic marker for impending sepsis in trauma patients.