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Influence of GM-CSF supplementation on PaO2/FiO2 index in septic patients


Granulocyte-Macrophage Colony-Stimulating Factor (rHuGM-CSF) is used in leucopenic febrile patients to enhance leukocyte production. It can prime resting monocytes and augment their inflammatory response [1]. It strongly up-regulates HLA-DR expression, LPS induced TNF-a monocyte secretion and down-regulates anti-inflammatory cytokines release [1].


Twenty septic patients, mean age 64.8 ± 3.7 (14 males) and illness severity scoring, SAPS II, 43.5 ± 4.5 were given subcutaneous molgramostin 200 µg q12 h for 3 consecutive days. We observed white blood count increase and PaO2/FiO2 index course having the same FiO2.


WBC count and PaO2/FiO2 index

Table 1

There was a statistically significant increase in WBC count between the 1st and 2nd, 3rd and 4th days (P < 0.01). There was no statistically significant PaO2/FiO2 index improvement between the 1st, 2nd and 4th days (P < 0.251 and 0.392) and index deterioration between the 1st and 3rd day (P < 0.478).


Despite significant WBC count increase after rHu GM-CSF supplementation, the PaO2/FiO2 index was not significantly altered. Molgramostin, when given in septic patients may improve the PaO2/FiO2 index except during the 3rd day of the major WBC count increase during which there is a nonstatistically significant decrease in this index by 3.1%. GM-CSF supplementation can be safely used without deteriorating pulmonary gas exchange function.


  1. Heumann D, Glauser M, Caladra T: Monocyte deactivation in septic shock. Curr Opin Infect Dis 1998, 11: 279-283.

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Myrianthefs, P., Karabatsos, E., Boutzouka, E. et al. Influence of GM-CSF supplementation on PaO2/FiO2 index in septic patients. Crit Care 5 (Suppl 1), P068 (2001).

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  • Septic Patient
  • Illness Severity
  • Cytokine Release
  • Exchange Function
  • White Blood Count