title: Assessing the immune status of critically ill trauma patients by flow cytometry.
abstract: BACKGROUND
  Unintentional injury or trauma remains the leading cause of death among young adults. About one fifth of these trauma patients require care in an intensive care unit (ICU) because of severity of injuries and comorbidities. Patients hospitalized in an ICU are at increased risk for nosocomial infections, such as urinary tract infections, pneumonia, bacteremia, and wound infections. Many of these patients will develop sepsis or septic shock, and some will progress to multiple organ failure and death. The balance between the proinflammatory and counterinflammatory immune response appears to be a driving factor in this progression. At present, there is no proposed method for the timely detection of the immune status in trauma patients, making rational decisions to use immune-altering therapies difficult.
  
  
  OBJECTIVE
  We demonstrate that flow cytometry, with its capabilities to characterize and/or enumerate (a) leukocyte subtypes, (b) leukocyte activation markers, (c) leukocyte-derived cytokines and microvesicles, and (d) leukocyte function is well suited to monitor the immune status of critically ill trauma patients.
  
  
  METHODS
  Information for the review was obtained from the extant literature.
  
  
  CONCLUSIONS
  We suggest that flow cytometry is a research method that might aid nurse scientists in investigating the immune status of critically ill patients, the recovery status of conditions such as hemorrhagic shock and tissue injury and the relationship between cancer disease progression and symptoms. Therefore, flow cytometry has the potential to broaden nursing research priority areas so that a comprehensive approach to understanding the cellular response is attained.
authors.affiliation: Joshua W. Kuethe, MD, is General Surgery Resident; Rachael Mintz-Cole, PhD, is MD Candidate; Bobby L. Johnson III, MD, is General Surgery Resident; and Emily F. Midura, MD, is General Surgery Resident, College of Medicine, University of Cincinnati, Ohio. Charles C. Caldwell, PhD, is Associate Professor, College of Medicine, Department of Surgery, Division of Research, University of Cincinnati, Ohio. Barbara St. Pierre Schneider, DNSc, RN, is Associate Professor, School of Nursing, University of Nevada, Las Vegas.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Kuethe
authors.forename: Rachael
authors.initials: R
authors.lastname: Mintz-Cole
authors.forename: Bobby L
authors.initials: BL
authors.lastname: Johnson
authors.forename: Emily F
authors.initials: EF
authors.lastname: Midura
authors.forename: Charles C
authors.initials: CC
authors.lastname: Caldwell
authors.forename: Barbara St Pierre
authors.initials: BS
authors.lastname: Schneider
mesh_terms: D056704:Adaptive Immunity / Q000502:physiology*; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000032:analysis; D055252:Cell-Derived Microparticles / Q000502:physiology; D018925:Chemokines / Q000097:blood; D016638:Critical Illness; D016207:Cytokines / Q000097:blood; D005434:Flow Cytometry; D006801:Humans; D007113:Immunity, Innate / Q000502:physiology*; D007694:Killer Cells, Natural / Q000502:physiology; D008214:Lymphocytes / Q000502:physiology; D017382:Reactive Oxygen Species / Q000097:blood; D018805:Sepsis / Q000276:immunology
chemical_list: D018925:Chemokines; D016207:Cytokines; D017382:Reactive Oxygen Species; D002097:C-Reactive Protein