tailieunhanh - Báo cáo y học: "Leukocyte phenotyping to stratify septic shock patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Leukocyte phenotyping to stratify septic shock patients. | Available online http content 13 2 127 Commentary Leukocyte phenotyping to stratify septic shock patients Jonathan E MeDunn and Richard S Hotchkiss Department of Anesthesiology Washington University School of Medicine 660 South Euclid Avenue Saint Louis MI 63110 USA Corresponding author Richard S Hotchkiss hotchkir@ See related research by Monserrat et al. http content 13 1 R26 Published 3 April 2009 This article is online at http content 13 2 127 2009 BioMed Central Ltd Critical Care 2009 13 127 doi cc7748 Abstract In a recent study conducted in a cohort of 52 septic patients Monserrat and coworkers found that profound failure of peripheral T cells to convert from a naive phenotype to an activated phenotype has positive predictive value in identifying patients who do not recover. These data support the hypothesis that failure of the innate immune system to engage the T-cell compartment contributes to sepsis mortality and provides motivation for the development and clinical evaluation of immunostimulatory therapies for patients with sepsis. Clinical scoring systems stratify patients on a population basis but they do not have sufficient sensitivity and specificity to answer fundamental questions about individuals. For instance is the patient infected responding to therapy or likely to recover In this issue Monserrat and coworkers 1 report their examination of surface marker expression on peripheral T cells over a 28-day period intensive care unit ICU admission through follow up in 52 patients with septic shock and 36 age-matched and sex-matched healthy control individuals. Consistent with previous reports this cohort of septic patients had significantly depressed T-cell numbers on ICU admission that persisted for weeks 2 3 . Monserrat and coworkers retrospectively classified patients as either survivors or nonsurvivors and showed that with the exception of injury severity assessments Acute Physiology and .