Base deficit after major trauma directly relates to neutrophil CD11b expression: a proposed mechanism of shock-induced organ injury.
OBJECTIVE
To determine whether expression of neutrophil integrin receptors is related to the degree of post-traumatic shock.


METHODS
Data were collected prospectively on patients with major trauma admitted to the surgical intensive care unit.


METHODS
Denver General Hospital, Colorado.


METHODS
17 severely injured adults.


RESULTS
The mean fluorescence intensity and per cent positive of neutrophil integrin receptors CD11 b, CD18 and CD11 a, and systolic blood pressure, blood transfusion, lactate and base deficit as indices of shock. CD11 b expression on circulating neutrophils was increased 6 and 12 h after trauma. After correcting for the other shock indices, base deficit predicted CD11 b expression at 12 h. CD11 b expression was negatively correlated with the circulating neutrophil count.


CONCLUSIONS
The degree of metabolic acidosis after trauma correlates directly with CD11 b receptor expression on circulating neutrophils. This relation may be the mechanism whereby post-traumatic shock results in neutrophil sequestration and neutrophil-mediated organ injury and failure.
Botha
A J
AJ
Department of Surgery, UCL Medical School, London. a.botha@ucl.ac.uk
Moore
F A
FA
Moore
E E
EE
Peterson
V M
VM
Goode
A W
AW
D000138:Acidosis / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018821:CD18 Antigens / Q000378:metabolism; D006801:Humans; D016169:Lymphocyte Function-Associated Antigen-1 / Q000378:metabolism; D016177:Macrophage-1 Antigen / Q000009:adverse effects / Q000378:metabolism*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D009504:Neutrophils / Q000502:physiology*; D011446:Prospective Studies; D012044:Regression Analysis; D012774:Shock, Traumatic / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D013997:Time Factors; D015854:Up-Regulation / Q000502:physiology
D018821:CD18 Antigens; D016169:Lymphocyte Function-Associated Antigen-1; D016177:Macrophage-1 Antigen