early natural killer cell counts in blood predict mortality in severe sepsis早期自然杀手细胞计数血液中预测严重脓毒症的死亡率.pdfVIP

Andaluz-Ojeda et al. Critical Care 2011, 15:R243 /content/15/5/R243 RESEARCH Open Access Early natural killer cell counts in blood predict mortality in severe sepsis 1 2 1 2 2 1 David Andaluz-Ojeda , Verónica Iglesias , Felipe Bobillo , Raquel Almansa , Lucía Rico , Francisco Gandía , 2 2 2 2 2 4 Ana Ma Loma , Concepción Nieto , Rosa Diego , Epifanio Ramos , Mercedes Nocito , Salvador Resino , 2 3 2 2* Jose M Eiros , Eduardo Tamayo , Raul Ortiz de Lejarazu and Jesús F Bermejo-Martin Abstract Introduction: Host immunity should play a principal role in determining both the outcome and recovery of patients with sepsis that originated from a microbial infection. Quantification of the levels of key elements of the immune response could have a prognostic value in this disease. Methods: In an attempt to evaluate the quantitative changes in the status of immunocompetence in severe sepsis over time and its potential influence on clinical outcome, we monitored the evolution of immunoglobulins (Igs) (IgG, IgA and IgM), complement factors (C3 and C4) and lymphocyte subsets (CD4+ T cells, CD8+ T cells, B cells (CD19+) and natural killer (NK) cells (CD3-CD16+CD56+)) in the blood of 50 patients with severe sepsis or septic shock at day 1, day 3 and day 10 following admission to the ICU. Results: Twenty-one patients died, ten of whom died within the 72 hours following admission to the ICU. The most frequent cause of death (n = 12) was multiorgan dysfunction syndrome. At day 1