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Phagocytosis of granulocytes is decreased in most patients with severe sepsis or septic shock

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Objectives

To investigate the phagocytotic activity of granulocytes during septic shock in postoperative/post-traumatic patients compared to that of healthy volunteers.

Methods

Over a six month period 19 patients with septic shock were monitored on a daily basis during their stay in the intensive care unit. Phagocytotic activity of granulocytes was determined by flow cytometry (Phagotest Orpegen, Heidelberg, Germany). The normal range of phagocytosis (expressed as mean intensity, MnI) was defined by a control group of 11 healthy volunteers.

Results

Phagocytosis of healthy volunteers was in the range of 34 MnI and 149 MnI. All survivors and 7 of 10 nonsurvivors (i.e. 84% of all patients) had a lower phagocytotic activity on more than 50% of days in septic shock compared to that of healthy volunteers. No patient had a phagocytosis greater than 149 MnI, the upper value of the normal range.

Conclusions

Phagocytosis is decreased in most patients during septic shock compared to healthy volunteers. Thus diminished phagocytotic activity may contribute to an impaired mechanism of bacterial elimination or a reduced resolution of infection in these patients. Moreover, phagocytotic activity of granulocytes does not discriminate survivors and nonsurvivors of septic shock.

Table Number of patients with more than 50% of days during septic shock within a distinct range of phagocytosis during septic shock compared to the normal range.

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Fischer, G., Barth, E., Remmele, R. et al. Phagocytosis of granulocytes is decreased in most patients with severe sepsis or septic shock. Crit Care 4, P58 (2000). https://doi.org/10.1186/cc778

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Keywords

  • Public Health
  • Intensive Care Unit
  • Flow Cytometry
  • Healthy Volunteer
  • Septic Shock