A simple method of predicting severe sepsis in burn patients

Christopher C. Baker, Donald D. Trunkey, William J. Baker

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    5 Scopus citations

    Abstract

    Twenty-six patients with major thermal injury were studied with sequential tests of immunocompetence. Five to 8 days after burn, 12 of 26 patients developed a marked depression in the phytohemagglutinin response (17 ± 8 percent of baseline) and an increase in suppression of the normal mixed leukocyte response (70 ± 13 percent suppression), which was followed by severe life-threatening sepsis 4 to 5 days later. Concomitant with this marked immunosuppression, the 12 patients developed red debris in the normally white mononuclear layer of the Ficoll-Hypaque density centrifugation gradients used to separate mononuclear cells. None of the 14 patients with minimal or no sepsis developed red debris in Ficoll-Hypaque gradients, nor did they show signs of immune depression by phytohemagglutinin or mixed leukocyte response assays. The only patients in the severe sepsis group who survived were those given aminoglycosides at the time red debris was observed on the Ficoll-Hypaque gradients. The presence of red debris on Ficoll-Hypaque separation appears to be a simple and reliable predictor of impending sepsis, which allows the use of antibiotics before the clinical onset of sepsis.

    Original languageEnglish (US)
    Pages (from-to)513-517
    Number of pages5
    JournalThe American Journal of Surgery
    Volume139
    Issue number4
    DOIs
    StatePublished - Apr 1980

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    ASJC Scopus subject areas

    • Surgery

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