[Simple references of the differential blood picture in assessing the immune status of immunologically compromised severely injured patients].
Infectious complications threaten the survival of severe traumatized patients in the intensive care unit. Major cause is a secondary immunodeficiency syndrome as a consequence of overloading the immune system by tissue debris and microbial antigens. Antigen presenting cells of the monocyte-macrophage line become activated unspecifically and produce immunosuppressive monokines, which modulate the T- and B-cell systems and weaken the specific immune response to antigens. In 150 severe injured patients (mean ISS 31; 15 patients died due to infections) we found that a decrease of lymphocytes below 1000/microliters and an increase of monocytes up to more than 1000/microliters within the first 24 hours correlate with developing infection in such a manner, that the lymphocyte/monocyte-quotient on day 1 was 2.0 in survivors and 0.9 in subjects, who died due to infections.
Holch
M
M
Abteilung für klinische Immunologie, Departement für Innere Medizin, Universitätsspital Zürich.
Grob
P J
PJ
Glinz
W
W
D003428:Cross Infection / Q000276:immunology*; D006801:Humans; D007958:Leukocyte Count; D007970:Leukopenia / Q000276:immunology*; D009104:Multiple Trauma / Q000276:immunology*; D012307:Risk Factors
Einfache Hinweise des Differentialblutbildes auf die Abwehrlage des immunologische belasteten Schwerverletzten.