PMID- 16525350
OWN - NLM
STAT- MEDLINE
DCOM- 20060718
LR  - 20220317
IS  - 1073-2322 (Print)
IS  - 1073-2322 (Linking)
VI  - 25
IP  - 2
DP  - 2006 Feb
TI  - Lipopolysaccharide-induced tumor necrosis factor alpha production and not 
      monocyte human leukocyte antigen-DR expression is correlated with survival in 
      septic trauma patients.
PG  - 129-34
AB  - Multiple trauma patients have an impaired immune system and thus frequently 
      develop life-threatening septic complications. Because there is an ongoing debate 
      on which are the most predictive immunologic parameters of clinical outcome, we 
      prospectively studied 19 multiple trauma patients with sepsis (mean age, 38.7 +/- 
      15.8 years; mean Injury Severity Score, 40.6 +/- 11.6) over a period of 14 days. 
      The following parameters were measured daily after admission to the intensive 
      care unit: ex vivo lipopolysaccharide (LPS)-induced tumor necrosis factor alpha 
      (TNF-alpha) production, monocyte human leukocyte antigen (HLA)-DR expression, 
      constitutive interleukin (IL) 6 secretion, white blood cell count, and C-reactive 
      protein. In addition, procalcitonin, neopterin, LPS-binding protein, and 
      constitutive TNF-alpha secretion were measured every third day. Immediately after 
      trauma, all patients had significantly lower levels of HLA-DR and ex vivo 
      LPS-stimulated TNF-alpha secretion than healthy controls (n = 7; P < 0.001). On 
      the day after clinical diagnosis of sepsis, before any other parameter differed 
      between survivors (n = 13) and nonsurvivors (n = 6), ex vivo LPS-induced 
      TNF-alpha secretion was significantly lower (P < 0.05) in nonsurvivors than in 
      survivors. We conclude that ex vivo LPS-induced TNF-alpha production is an 
      earlier predictor of clinical outcome in multiple trauma patients with sepsis 
      than monocyte HLA-DR expression, constitutive IL-6 secretion, or any other 
      parameter assessed.
FAU - Ploder, Martin
AU  - Ploder M
AD  - Surgical Research Laboratories, Medical University Of Vienna, 8H G9.13 Waehringer 
      Guertel 18-20, A-1090 Vienna, Austria.
FAU - Pelinka, Linda
AU  - Pelinka L
FAU - Schmuckenschlager, Claudia
AU  - Schmuckenschlager C
FAU - Wessner, Barbara
AU  - Wessner B
FAU - Ankersmit, Hendrik Jan
AU  - Ankersmit HJ
FAU - Fuerst, Walter
AU  - Fuerst W
FAU - Redl, Heinz
AU  - Redl H
FAU - Roth, Erich
AU  - Roth E
FAU - Spittler, Andreas
AU  - Spittler A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Shock
JT  - Shock (Augusta, Ga.)
JID - 9421564
RN  - 0 (Blood Proteins)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Lipopolysaccharides)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Proteins/biosynthesis
MH  - Cells, Cultured
MH  - Female
MH  - Gene Expression Regulation/*drug effects
MH  - HLA-DR Antigens/*biosynthesis
MH  - Humans
MH  - Lipopolysaccharides/*pharmacology
MH  - Male
MH  - Middle Aged
MH  - Monocytes/*metabolism/pathology
MH  - Multiple Trauma/complications/*metabolism/mortality/pathology
MH  - Outcome Assessment, Health Care
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Sepsis/etiology/*metabolism/mortality/pathology
EDAT- 2006/03/10 09:00
MHDA- 2006/07/19 09:00
CRDT- 2006/03/10 09:00
PHST- 2006/03/10 09:00 [pubmed]
PHST- 2006/07/19 09:00 [medline]
PHST- 2006/03/10 09:00 [entrez]
AID - 00024382-200602000-00005 [pii]
AID - 10.1097/01.shk.0000191379.62897.1d [doi]
PST - ppublish
SO  - Shock. 2006 Feb;25(2):129-34. doi: 10.1097/01.shk.0000191379.62897.1d.