Longitudinal analysis of neutrophil superoxide anion generation in patients with septic shock.

摘要: OBJECTIVE To examine polymorphonuclear leukocyte respiratory burst function serially in patients with septic shock. DESIGN Prospective, longitudinal, descriptive study. SETTING Adult and pediatric (university hospital) intensive care units. PATIENTS Eight critically ill patients, shock eight without evidence of infection or sepsis. MEASUREMENTS AND MAIN RESULTS Severity patient illness was estimated using the Acute Physiology Chronic Health Evaluation (APACHE II) scoring system. For each patient, neutrophil superoxide anion synthesis assayed spectrophotometrically multiple blood samples over a period 7 to 12 days after clinical identification The initial sample obtained < hrs admission. Reaction velocities initially, at 2 3 mins, 4 5 mins (nmol anion/min/10(6) neutrophils), extent reaction anion/5 mins/10(6) neutrophils) were determined for assay. On day admission, mean APACHE II score velocity group 21.5 +/- 10 4.6 nmol neutrophils, respectively. Over next days, as recovered, there significant (paired t-test) decrease scores (p .005) increase .0005). correlated accompanying (r2 = .46). Neutrophil generation not suppressed compared remained normal throughout evaluation period. CONCLUSIONS In vitro is significantly depressed during early As improve clinically, quantitated by decreasing scores, recovers, approaching values.