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 language | English (US) |
|---|---|
| Pages (from-to) | 513-517 |
| Number of pages | 5 |
| Journal | The American Journal of Surgery |
| Volume | 139 |
| Issue number | 4 |
| DOIs | |
| State | Published - 1980 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
Cite this
A simple method of predicting severe sepsis in burn patients. / Baker, Christopher C.; Trunkey, Donald; Baker, William J.
In: The American Journal of Surgery, Vol. 139, No. 4, 1980, p. 513-517.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A simple method of predicting severe sepsis in burn patients
AU - Baker, Christopher C.
AU - Trunkey, Donald
AU - Baker, William J.
PY - 1980
Y1 - 1980
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0018906533&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0018906533&partnerID=8YFLogxK
U2 - 10.1016/0002-9610(80)90329-3
DO - 10.1016/0002-9610(80)90329-3
M3 - Article
C2 - 6445167
AN - SCOPUS:0018906533
VL - 139
SP - 513
EP - 517
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 4
ER -