Critical Care

, 18:P227 | Cite as

Flow-cytometric analysis in traumatic brain injury to evaluate immunosuppression

  • S Di Valvasone
  • L Perretta
  • M Bonizzoli
  • F Liotta
  • F Annunziato
  • F Socci
  • P Ruggiano
  • A Peris
Open Access
Poster presentation

Keywords

Public Health Clinical Study Traumatic Brain Injury Brain Injury Emergency Medicine 

Introduction

Flow-cytometric analysis is still restricted to cancer and immunocompromised patients. There are no clinical studies that evaluate the immunological changes in traumatic brain injury (TBI) patients. The objective of this study is to determine whether patients with severe TBI (GCS <9) manifest early (<48 hours after injury) signs of immunosuppression and whether this condition increases the incidence of infection during the ICU stay.

Methods

We retrospectively analyzed data from 54 patients, including 10 patients with isolated brain injury and 44 patients with brain and extracranial injuries. The flow-cytometric analysis was performed within 48 hours of trauma. Collected data are shown in Table 1.
Table 1

Collected data

Age (years), mean ± SD

55.43 ± 23.12

Sex (M/F)

44/10

Body mass index, mean ± SD

25.51 ± 2.69

ISS, mean ± SD

29.04 ± 26.57

RTS, mean ± SD

5.76 ± 1.53

TRISS, mean ± SD

68.73 ± 28.77

Admission SAPS II, mean ± SD

44.96 ± 14.87

Admission GCS, mean ± SD

7.63 ± 3.88

Flow-cytometric analysis day (days), mean ± SD

1.69 ± 3.34

Discharge GCS, mean ± SD

10.48 ± 3.19

ICU LOS, mean ± SD

10.67 ± 8.08

Results

Preliminary analysis is limited to descriptive statistics that show an immediate immunosuppression condition after TBI, as established by reduction of CD4+ T lymphocytes and CD8+ T lymphocytes. Significant data are collected in Table 2.
Table 2

Flow-cytometric data

  

Normal value

WBC (×109/l)

10.67 ± 4.82

4 to 10

Total lymphocytes (×106/l)

1,123.15 ± 547.02

1,200 to 3,000

CD3+ lymphocytes (×106/l)

67.11 ± 11.86

1,100 to 1,700

CD3+CD4+ lymphocytes (×106/l)

493.07 ± 313.92

600 to 1,400

CD3+CD8+ lymphocytes (×106/l)

250.65 ± 171.94

300 to 900

CD4+DRM+ lymphocytes (×106/l)

23.19 ± 15.09

 

CD8+DR+ lymphocytes (×106/l)

16.26 ± 20.83

 

Conclusion

In severe TBI patients, an immunosuppression state is early developed. It is relevant to establish whether this condition could affect the course and prognosis of ICU patients.

Copyright information

© Di Valvasone et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • S Di Valvasone
    • 1
  • L Perretta
    • 1
  • M Bonizzoli
    • 1
  • F Liotta
    • 1
  • F Annunziato
    • 1
  • F Socci
    • 1
  • P Ruggiano
    • 1
  • A Peris
    • 1
  1. 1.Careggi HospitalFirenzeItaly

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