 |
|
Polymorphonuclear Leukocyte ActivationAn Early Marker of the Postsurgical Sepsis Response
Christian H. Wakefield;
P. Declan Carey, FRCS(I);
Sharmila Foulds;
John R. T. Monson, MD, FRCS(I);
Pierre J. Guillou, MD, FRCS(Eng)
Arch Surg. 1993;128(4):390-395.
Abstract
| |
• It has been suggested that major surgery induces polymorphonuclear leukocyte (PMNL) dysfunction, which exposes patients to the development of sepsis. Conversely, the sepsis response and multisystem organ failure in patients after surgery is thought to be mediated by activated PMNLs. In a preliminary attempt to investigate this paradox, we studied functional (hydrogen peroxide production) and phenotypic (the adhesion/complement receptor CD11b) markers of PMNL activation in 28 patients undergoing elective major resectional surgery; 11 (39%) of these patients developed postoperative sepsis (the septic group). The mean (SEM) preoperative level of neutrophil CD11b expression (97.8 [6.2] mean channel fluorescence [MCF] and 101.42 [7.9] MCF; P=.74) and hydrogen peroxide production (109.51 [4.91] MCF and 104.53 [6.3] MCF; P=.5) were similar for the uncomplicated and septic groups, respectively. However, on the first postoperative day, both mean CD11b expression and hydrogen peroxide production were greater in those patients who subsequently developed postoperative sepsis (192.5 [38] MCF vs 128.6 [8.1] MCF for the septic group vs the uncomplicated group, respectively [P<.05], and 120.43 [2.56] MCF vs 109.61 [3.05] MCF for the septic group vs the uncomplicated group, respectively [P<.0001]). We suggest that an exaggerated PMNL activation response to surgery is an early event in those patients destined to develop postsurgical sepsis.
(Arch Surg. 1993;128:390-395)
Author Affiliations
From the Academic Surgical Unit, St Mary's Hospital Medical School, London, England.
Footnotes
Accepted for publication August 23, 1992.
Presented at the 12th Annual Meeting of the Surgical Infection Society, Los Angeles, Calif, April 10, 1992.
Reprint requests to the Academic Surgical Unit, Level 10, Queen Elizabeth the Queen Mother Wing, St Mary's Hospital Medical School, London, England W2 1NY (Dr Guillou).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Inhibition of haem oxygenase activity increases leukocyte accumulation in the liver following limb ischaemia-reperfusion in mice
Wunder et al.
J. Physiol. 2002;540:1013-1021.
ABSTRACT
| FULL TEXT
Systemic inflammation and cardiac surgery: an update
Asimakopoulos
Perfusion 2001;16:353-360.
ABSTRACT
Anaesthesia with propofol decreases FMLP-induced neutrophil respiratory burst but not phagocytosis compared with isoflurane
Heine et al.
Br J Anaesth 2000;85:424-430.
ABSTRACT
| FULL TEXT
Effects of cardiopulmonary bypass on leukocyte and endothelial adhesion molecules
Asimakopoulos and Taylor
Ann. Thorac. Surg. 1998;66:2135-2144.
ABSTRACT
| FULL TEXT
Inhibition of Leukocyte Emigration Induced During the Systemic Inflammatory Reaction In Vivo Is Not Due to IL-8
Schleiffenbaum et al.
J. Immunol. 1998;161:3631-3638.
ABSTRACT
| FULL TEXT
PAF and CD18 mediate neutrophil infiltration in upper gastrointestinal tract during intra-abdominal sepsis
Beyer et al.
Am. J. Physiol. Gastrointest. Liver Physiol. 1998;275:G467-G472.
ABSTRACT
| FULL TEXT
Interleukin-10: A Role in the Development of Postoperative Immunosuppression
Klava et al.
Arch Surg 1997;132:425-429.
ABSTRACT
Leukocyte Activation in the Peripheral Blood of Patients With Cirrhosis of the Liver and SIRS: Correlation With Serum Interleukin-6 Levels and Organ Dysfunction
Rosenbloom et al.
JAMA 1995;274:58-65.
ABSTRACT
Immune Function in Patients Undergoing Open vs Laparoscopic Cholecystectomy
Redmond et al.
Arch Surg 1994;129:1240-1246.
ABSTRACT
Ranitidine Improves Postoperative Monocyte and Neutrophil Function
Nielsen et al.
Arch Surg 1994;129:309-315.
ABSTRACT
|
