儿童严重败血症中长期感染和二次感染的危险因素
Zachary Aldewereld1,2, Brendan Connolly3, Russell K Banks4
1Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh, 4401 Penn Ave, FP Suite 2000, Pittsburgh, PA, 15224, USA. aldewereldzt@upmc.edu.
Infection
|August 8, 2024
概括
持续性淋巴缺血和中性缺血是败血症患者二次感染的关键风险因素,导致结果更差. 识别这些免疫标志物有助于预测和管理败血症并发症.
科学领域:
- 关键护理医学 关键护理医学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 败血症是全球死亡率和发病率的主要原因之一.
- 诸如持续感染和二次感染等并发症会使败血症的结果恶化.
- 识别这些并发症的危险因素对于改善患者护理至关重要.
研究的目的:
- 描述与败血症患者长期和二次感染相关的风险因素.
- 研究免疫抑郁的实验室标记在预测这些并发症中的作用.
主要方法:
- 来自401名败血症患者的临床数据的二次分析.
- 确定的长期感染 (≥7天) 和二次感染 (≥3天).
- 检查了实验室标记物,包括持续的淋巴缺血症 (绝对淋巴细胞数量<1000细胞/μL 5天内两次) 和中性质缺血症 (绝对中性粒细胞数量<1000细胞/μL 5天内两次),在免疫功能低下和免疫能力较强的组.
主要成果:
- 疾病严重程度,免疫功能受损状态,侵入性手术,以及与长期/二次感染相关的感染部位.
- 持续的淋巴缺血和中性缺血与长期和二次感染有关.
- 持续性淋巴缺血独立预测了免疫功能低下 (aOR=14.19) 和免疫能力强 (aOR=2.09) 患者的二次感染.
- 在免疫功能低下的患者中,持续性中性独立预测了二次感染 (aOR=5.34).
结论:
- 免疫抑制的实验室标志物,特别是淋巴缺血,可以预测败血症的二次感染.
- 淋巴缺血是一个独立的风险因素,用于免疫功能低下和免疫能力强的败血症患者的二次感染.
- 二次和长期感染与增加的死亡率有关.
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