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Intensive Care Medicine Experimental

Table 7 Experimental conduct and exclusion criteria of neutrophil respiratory burst studies

From: Uncontrolled sepsis: a systematic review of translational immunology studies in intensive care medicine

Author Study population Sample timing Definition of sepsis Microbiology results provided Independent adjudication of sepsis diagnosis Exclusion criteria immunosuppressive disease Exclusion criteria malignancy Primary conclusion of study (in relation to neutrophil respiratory burst)
Time of first sample No. samples (time span)
Santos [12] Sepsis 72 h (Dx sepsis); 48 h (organ failure); onset of septic shock 2 (7 days) 1 A,B,C N N Y Y Reactive oxygen species production by neutrophils is increased in sepsis, and [it] is associated with poor outcome
Gorgulu [19] Trauma 24 h (Hosp Adm) 1 2 A,B,C N N Y N Fas stimulation of septic neutrophils promotes apoptosis and inhibits functionality, partially by non-apoptotic signalling
Bruns [13] Sepsis (cirrhotics) 24 h (Hosp Adm) 1 5 Y N Y N [Within cirrhotic patients] augmented neutrophil ROS release in response to E. coli…becomes exhausted in the presence of infection
Shih [20] Trauma 24 h (Hosp Adm) 2 (3 days) N N N Y Y Plasma migration inhibitory factor is one of the important factors responsible for early neutrophil activation
Kasten [21] Trauma 48 to 72 h (Post-trauma) 1 N N N Y N Following trauma, there are concurrent and divergent immunological responses…hyper-inflammatory response by the innate arm…and hypo-inflammatory response by the adaptive arm
Valente [22] Trauma 48 h (Hosp Adm) 3 (5 days) N N N Y N Injury results in differences in innate immune function in the elderly when compared with controls
Kawasaki [26] Elective surgery Pre-insult 5 (4 days) N N N Y N The innate immune system is suppressed from the early period of upper abdominal surgery
Frohlich [27] Elective surgery Pre-insult 2 (end of anaesth) N n/a n/a Y Y [This study demonstrates] suppression of neutrophil function by propofol in vitro [but not] in vivo
Martins [14] Sepsis 48 h (ICU Adm) 1 1 B,C Y N Y Y Neutrophil function is enhanced in patients with sepsis
Barth [15] Sepsis ? 6 (5 days) 1C (>4d) Y N N N Endogenous G-CSF increases neutrophil function in patients with severe sepsis and septic shock
Mariano [16] Sepsis (renal replacement therapy) ? 4 (1 day) 1, B,D N N N N Sera from septic patients [demonstrate] an enhanced priming activity on neutrophils [that is] reduced by ultrafiltration
Quaid [23] Trauma 24 h (Hosp Adm) 1 N N N N N [After severe trauma] IL-8 and GROα lose the ability to regulate the TNFα induced respiratory burst
Wiezer [28] Elective surgery Pre-insult 5 (7 days) “clinical criteria” N N Y N Patients undergoing liver resection have an increased activation of leukocytes compared with other major abdominal surgery [that is partially reversed] by endotoxin neutralisation…with rBPI21
Ahmed [17] Sepsis 72 h (Proof of infection) 1 1 A,B Y Y Y Y Septic patients deliver fewer neutrophils to secondary inflammatory sites
Shih [29] Trauma/Surgery 24 h (Hosp adm) 3+ (7 days) 1 A,B,C N N Y Y Surgery after [trauma] has no effect on the priming of neutrophils
Ertel [24] Trauma 24 h (Hosp adm) 2 (3 days) N N N Y N Severe trauma stimulates acute-phase priming in neutrophils
Ogura [25] Trauma 24 h (Post-trauma) 4 + 1 (21 days) 2 A B C Y N N N Severe trauma stimulates acute-phase priming in neutrophils
Pascual [18] Sepsis 24 h (ICU adm) 1 1 A C Y N N N Plasma of septic patients may have a profound effect on neutrophil response [and] differentiates between sepsis and non-sepsis samples
  1. Sample timing: Were control samples taken at the same time point after the inflammatory stimulus as subject samples? When was the first sample taken from the subject? How many samples were taken for each subject in total and over what time span? Sepsis criteria: The criteria used to enrol subjects into the study. Where subgroups of these criteria were used (e.g. septic shock) these are detailed. 0, not stated; 1, ACCP/SCCM 1992 Consensus Conference [73]; 2, ACCP/SCCM Consensus Conference 2001 [74]; 3, SSC Consensus Conference 2008 [75]; 4, CDC NNIC [86]; 5, Microbiology and clinical assessment; 6, Postmortem identification of infection; N, infection not considered; question mark (?), criteria not described. Sepsis severity groups enrolled: A = sepsis, B = severe sepsis, C = septic shock, D = acute renal failure, E = SIRS. Microbiology documentation: Were causative organisms clearly isolated and identified? Were additional steps taken to define whether the subject had sepsis beyond the initial clinical diagnosis, i.e. retrospective review of the case in light of subsequent information?
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