Occurrence of marked sepsis-induced immunosuppression in pediatric septic shock: a pilot study

Occurrence of marked sepsis-induced immunosuppression in pediatric septic shock: a pilot study Background: While the process of sepsis‑ induced immunosuppression is now well described in adults, very lit‑ tle information is available on immune functions in pediatric sepsis. The current study investigated this in children with septic shock by performing immunomonitoring, including both innate (monocyte human leukocyte antigen‑ DR, mHLA‑ DR, expression) and adaptive immunity (lymphocyte subsets count), as well as cytokine concentrations (IL‑ 6, IL‑ 8, IL‑ 10, IL‑ 1Ra, TNF‑ α, IFN‑ γ). Subsequent objectives were to assess the associations between inflammatory response, potential immunosuppression and secondary acquired infection occurrence. Methods: Single‑ center prospective observational study, including children aged between 1 month and 18 years admitted to pediatric intensive care unit (PICU) for septic shock. Age‑ matched controls were children hospitalized for elective surgery without any infectious criteria. Blood was sampled at day 1–2, 3–5, and 7–9 after sepsis onset. mHLA‑ DR and lymphocyte subsets count were measured by flow cytometry and cytokine concentrations by Luminex technology. Results: A total of 26 children and 30 controls were included. Patients had lymphopenia, and mHLA‑ DR levels were significantly lower than controls at each time point ( p < 0.0001). All cytokines peaked at day 1–2. Children with sec‑ ondary acquired http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Intensive Care Springer Journals

Occurrence of marked sepsis-induced immunosuppression in pediatric septic shock: a pilot study

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Publisher
Springer Journals
Copyright
Copyright © 2018 by The Author(s)
Subject
Medicine & Public Health; Intensive / Critical Care Medicine; Emergency Medicine; Anesthesiology
eISSN
2110-5820
D.O.I.
10.1186/s13613-018-0382-x
Publisher site
See Article on Publisher Site

Abstract

Background: While the process of sepsis‑ induced immunosuppression is now well described in adults, very lit‑ tle information is available on immune functions in pediatric sepsis. The current study investigated this in children with septic shock by performing immunomonitoring, including both innate (monocyte human leukocyte antigen‑ DR, mHLA‑ DR, expression) and adaptive immunity (lymphocyte subsets count), as well as cytokine concentrations (IL‑ 6, IL‑ 8, IL‑ 10, IL‑ 1Ra, TNF‑ α, IFN‑ γ). Subsequent objectives were to assess the associations between inflammatory response, potential immunosuppression and secondary acquired infection occurrence. Methods: Single‑ center prospective observational study, including children aged between 1 month and 18 years admitted to pediatric intensive care unit (PICU) for septic shock. Age‑ matched controls were children hospitalized for elective surgery without any infectious criteria. Blood was sampled at day 1–2, 3–5, and 7–9 after sepsis onset. mHLA‑ DR and lymphocyte subsets count were measured by flow cytometry and cytokine concentrations by Luminex technology. Results: A total of 26 children and 30 controls were included. Patients had lymphopenia, and mHLA‑ DR levels were significantly lower than controls at each time point ( p < 0.0001). All cytokines peaked at day 1–2. Children with sec‑ ondary acquired

Journal

Annals of Intensive CareSpringer Journals

Published: Mar 13, 2018

References

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