title: Phagocyte priming as a prognostic indicator in the intensive care unit.
abstract: BACKGROUND
  The purpose of this study was to study the temporal changes in circulating phagocyte respiratory burst activity and its relationship to mortality in intensive care unit (ICU) patients.
  
  
  METHODS
  Thirty-seven consecutive patients over a 3-week period were studied on their first, third, and seventh day of admission to the regional ICU in Northern Ireland. Blood samples were assayed for respiratory burst activity using luminol-enhanced whole blood chemiluminescence.
  
  
  RESULTS
  Compared with survivors, nonsurvivors exhibited significantly higher Acute Physiology and Chronic Health Evaluation II scores, a base deficit, and reduced phagocyte activity (median [interquartile range]) (24.00% [18.00%, 56.00%] vs. 38.00% [30.00%, 63.50%], p = 0.047, Mann-Whitney U test) on day 3 of admission to the ICU.
  
  
  CONCLUSIONS
  Temporal changes in phagocyte activation dependent on the underlying insult were seen in ICU patients. Furthermore, the degree of phagocyte activation was able to distinguish between survivors and nonsurvivors on day 3 of admission to the ICU. Nonsurvivors exhibited reduced phagocyte activation, suggesting patients at risk of mortality exhibit systemic anergy.
authors.affiliation: Department of Surgery, Queen's University of Belfast, Northern Ireland. k.mccallion@qub.ac.uk
authors.forename: Kevin
authors.initials: K
authors.lastname: McCallion
authors.forename: Danny F
authors.initials: DF
authors.lastname: McAuley
authors.forename: Denis W
authors.initials: DW
authors.lastname: Harkin
authors.forename: Conor P
authors.initials: CP
authors.lastname: McCarroll
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Brown
authors.forename: Gavin
authors.initials: G
authors.lastname: Lavery
authors.forename: Keith R
authors.initials: KR
authors.lastname: Gardiner
mesh_terms: D018806:APACHE; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D016022:Case-Control Studies; D004396:Coloring Agents; D003422:Critical Care; D016638:Critical Illness / Q000145:classification / Q000401:mortality* / Q000628:therapy; D016002:Discriminant Analysis; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007249:Inflammation / Q000276:immunology; D015850:Interleukin-6 / Q000097:blood; D008163:Luminescent Measurements; D008165:Luminol; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland / Q000453:epidemiology; D010586:Phagocytes / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I; D016897:Respiratory Burst / Q000276:immunology; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D015703:Antigens, CD; D004396:Coloring Agents; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D008165:Luminol