Abstract:
PURPOSE:Septic shock induces a decrease in dendritic cells (DCs) that may contribute to sepsis-induced immunosuppression. We analyzed the time course of circulating DCs in patients with septic shock and its relation to susceptibility to intensive care unit (ICU)-acquired infections. METHODS:We enrolled adult patients with septic shock (n = 43), non-septic shock (n = 29), and with sepsis without organ dysfunction (n = 16). Healthy controls (n = 16) served as reference. Blood samples were drawn on the day of shock (day 1), then after 3 and 7 days. Myeloid (mDC) and plasmacytoid (pDC) DCs were counted by flow cytometry. Cell surface HLA-DR expression was analyzed in both DC subsets. RESULTS:At day 1, median mDC and pDC counts were dramatically lower in septic shock patients as compared to healthy controls (respectively, 835 mDCs and 178 pDCs/ml vs. 19,342 mDCs and 6,169 pDCs/ml; P < 0.0001) but also to non-septic shock and sepsis patients (P < 0.0001). HLA-DR expression was decreased in both mDCs and pDCS within the septic shock group as compared to healthy controls. DC depletion was sustained for at least 7 days in septic shock patients. Among them, 10/43 developed ICU-acquired infections after a median of 9 [7.5-11] days. At day 7, mDC counts increased in patients devoid of secondary infections, whereas they remained low in those who subsequently developed ICU-acquired infections. CONCLUSION:Septic shock is associated with profound and sustained depletion of circulating DCs. The persistence of low mDC counts is associated with the development of ICU-acquired infections, suggesting that DC depletion is a functional feature of sepsis-induced immunosuppression.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Grimaldi D,Louis S,Pène F,Sirgo G,Rousseau C,Claessens YE,Vimeux L,Cariou A,Mira JP,Hosmalin A,Chiche JDdoi
10.1007/s00134-011-2306-1subject
Has Abstractpub_date
2011-09-01 00:00:00pages
1438-46issue
9eissn
0342-4642issn
1432-1238journal_volume
37pub_type
杂志文章abstract:OBJECTIVE:To compare the effectiveness of traditional and online teaching methods for educating anesthesiology residents in the principles and practice of difficult airway management. DESIGN:Prospective, randomized, controlled trial. SETTING:University hospital. PARTICIPANTS:Two randomly selected groups, each contai...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-005-2561-0
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. DESIGN:The bias flow nitrogen washout techn...
journal_title:Intensive care medicine
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s00134-009-1545-x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Alterations in coagulation, including elevated pulmonary and systemic concentrations of urokinase, are frequent in patients with acute lung injury (ALI). Urokinase potentiates neutrophil activation and contributes to the severity of pulmonary injury in preclinical models of ALI. The objective of this study wa...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-007-0930-6
更新日期:2008-02-01 00:00:00
abstract::Optimal fluid management is one of the main challenges in the care of the critically ill. However, the physiological parameters that are commonly monitored and used to guide fluid management are often inadequate and even misleading. From 1987 to 1989 we published four experimental studies which described a method for ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-014-3285-9
更新日期:2014-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00134-013-2826-y
更新日期:2013-05-01 00:00:00
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更新日期:2006-06-01 00:00:00
abstract::This report identifies some of the risk factors underlying the acquisition of hospital infections in patients admitted to Intensive Care Units (ICUs). Infection rates vary in different institutes and in different types of ICUs. Patients are particularly prone to septicaemia and respiratory infections and the underlyin...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01709700
更新日期:1990-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
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更新日期:2014-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/BF01708963
更新日期:1994-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-09-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:1996-03-01 00:00:00
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journal_title:Intensive care medicine
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doi:10.1007/s00134-011-2230-4
更新日期:2011-08-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 社论
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更新日期:2018-11-01 00:00:00
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更新日期:2003-09-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:1988-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2323-4
更新日期:2004-08-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-02-01 00:00:00
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更新日期:2000-03-01 00:00:00
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更新日期:2003-06-01 00:00:00
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pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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更新日期:1994-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0833-6
更新日期:2007-12-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00134-015-4064-y
更新日期:2016-02-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 已发布勘误
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更新日期:2020-10-14 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-015-3921-z
更新日期:2015-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2018-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-09-01 00:00:00