Volume 4 Supplement 1
Neurosurgical patients admitted to intensive care units (ICU) exhibit a systemic inflammatory response
© Current Science Ltd 2000
Published: 21 March 2000
Neurosurgical patients are at risk of multi-organ dysfunction. It was hypothesised that those patients requiring ICU admission would exhibit evidence of a systemic inflammatory response.
Over a period of 3 weeks, all neurosurgical patients (elective and emergency) admitted to a regional ICU had blood taken on the 1st and 3rd morning after admission. Blood was also taken from controls. Neutrophil (PMN) respiratory burst activity was assayed over 17.3 min using a BioOrbit 1251 Luminometer to detect diluted (1:20) whole blood chemiluminescence (CL) in the presence of luminol. Circulating and maximal CL were measured by stimulation with phorbol 1,2-myristate 1,3-acetate in the absence or presence of tumour necrosis factor alpha (TNF) respectively (Fig. 1). The peak signal for each was obtained and the maximal value dived by the circulating value. This ratio represents the capacity to increase circulating respiratory burst activity. Soluble p55 TNF receptor (anti-inflammatory marker) and interleukin 6 (IL6, pro-inflammatory marker) were measured. Clinical parameters were recorded.
Median [interquartile range, IQR] APACHE II scores were 22 (17-26) and 24 (11-27) on days 1 and 3 respectively.
p55 TNF (ng/ml)
Day 1 (n=15)
Day 3 (n=7)