title: [Changes in the cell-mediated immune system in post-traumatic sepsis].
abstract: OBJECTIVE
  We studied the alterations of cell-mediated immunity (CMI) in polytrauma patients and its relation with sepsis.
  
  
  METHODS
  a prospective study.
  
  
  METHODS
  ICU, Ospedale Maggiore, Bologna (Italy).
  
  
  METHODS
  We included in the study 42 patients with at least two of following criteria: 1) Trauma Score < or = 12; 2) Abbreviated Injury Score > or = 4; 3) Arterial Pressure on admission < or = 80 mmHg; 4) Injury Severity Score > or = 16. CMI examinations were carried out at three different post-traumatic times (T0-T2). Seventeen patients developed a sepsis within the first eight days from admission.
  
  
  RESULTS
  Sepsis caused a temporary impairment in some lymphocyte subsets at T2. The patients who developed sepsis showed a significant subset percentage difference for CD3, CD3 activated (p < 0.05) and for interleukin-2 receptor (IL-2R) (p < 0.01) in comparison with the non septic group. At T2, the seven septic patients who died, showed a marked depression of IL-2 values (0.37 +/- 0.12 UI/ml) in comparison with the values of septic patients who survived (0.66 +/- 0.25 UI/ml; p < 0.01) and with the group of non septic patients (0.83 +/- 0.5 UI/ml; p < 0.001). Septic patients who had a IL-2 value of 0.45 or lower had a mortality of 75%. IL-2 values showed a specificity of 89% and a sensibility of 75% in predicting mortality in septic trauma patients.
  
  
  CONCLUSIONS
  We believe that in polytrauma patients IL-2 values monitoring could be a reliable index of the disfunction of CMI and that IL-2R sieric levels could be a diagnostic marker of impending sepsis.
authors.affiliation: I Servizio di Anestesia e Rianimazione, Ospedale Maggiore C. A. Pizzardi, USL n. 27, Bologna.
authors.forename: M
authors.initials: M
authors.lastname: Vinelli
authors.forename: F
authors.initials: F
authors.lastname: Ferrari
authors.forename: V
authors.initials: V
authors.lastname: Zanni
authors.forename: F
authors.initials: F
authors.lastname: Cancellieri
authors.forename: M L
authors.initials: ML
authors.lastname: Schiattone
authors.forename: M
authors.initials: M
authors.lastname: Cicognani
authors.forename: L
authors.initials: L
authors.lastname: Procaccio
mesh_terms: D000328:Adult; D006801:Humans; D007111:Immunity, Cellular; D007239:Infections / Q000209:etiology / Q000276:immunology / Q000401:mortality*; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000276:immunology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate
vernacular_title: Alterazioni del sistema immunitario cellulo-mediato nella sepsi post-traumatica.