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Intensive Care Medicine

, Volume 30, Issue 2, pp 331–334 | Cite as

Blood polymorphonuclear leukocyte migration as a predictive marker for infections in severe trauma: comparison with various inflammation parameters

  • Gerd Egger
  • Reingard Aigner
  • Andreas Glasner
  • Herwig P. Hofer
  • Heike Mitterhammer
  • Sieglinde Zelzer
Brief Report

Abstract

Objective

To assess in patients with multiple trauma the relevance of the following as predictive markers for infections: the inflammation parameters white blood count, body temperature, blood polymorphonuclear leukocyte (PMN) migration; blood levels of C-reactive protein, PMN elastase, procalcitonin, neopterin, interleukin 6, interleukin 8, malondialdehyde, total antioxidative status; the stress parameters cortisol and lactate.

Design

Prospective observational cohort study.

Setting

Intensive Care Unit of a university surgical department.

Patients

Twenty-six patients with multiple trauma of differing severity.

Measurements and results

Trauma severity was estimated by the ISS. PMN migration upon F-Met-Leu-Phe stimulation was determined in fresh whole blood in a ready-for-use, one-way membrane filter assay and evaluated by automated image analysis. The other parameters were measured with commercially available tests. During hospitalization, nine patients developed infections, and 17 patients were free of infection. PMN migration below a critical minimum preceded infections in eight of the infected, but occurred in only three of the non-infected patients (positive/negative predictive values 0.72/0.93; sensitivity/specificity 0.88/0.82; likelihood ratio 5.0). Fever (≥38.0 °C) had predictive values of 0.83/0.80 and a high likelihood ratio of 9.4, but a low sensitivity/specificity of 0.55/0.94. The other parameters were without significance. Procalcitonin, elastase, C-reactive protein, neopterin and lactate correlated positively with the injury severity score.

Conclusion

PMN migration proved to be a highly sensitive predictive marker for infections. The whole-blood PMN migration test may facilitate early aggressive antimicrobial therapy.

Keywords

PMN Migration Trauma Infection Predictive Marker 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Gerd Egger
    • 1
  • Reingard Aigner
    • 2
  • Andreas Glasner
    • 3
  • Herwig P. Hofer
    • 4
  • Heike Mitterhammer
    • 5
  • Sieglinde Zelzer
    • 6
  1. 1.Institute of PathophysiologyKarl- Franzens University, GrazGrazAustria
  2. 2.Department of Nuclear MedicineUniversity Hospital, GrazGrazAustria
  3. 3.Department of Obstetrics and GynecologyUniversity Hospital, Graz GrazAustria
  4. 4.Department of TraumatologyUniversity Hospital, GrazGrazAustria
  5. 5.Department of Internal MedicineUniversity Hospital, GrazGrazAustria
  6. 6.Institute of Clinical Chemistry and Laboratory MedicineKarl Franzens University, GrazGrazAustria

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