Intraoperative hypothermia is still common and should therefore receive serious attention. Advanced age, the use of a laminar airflow operating room and general surgeries are high risk factors of hypothermia.

Vitamin E (VE), consisting of tocopherols, tocotrienols and the derivatives, serves as a lipid-soluble antioxidant providing nutrients to animals including fish (Bramley et al., 2000). Its primary function is to act as a free radical scavenger that protects cells and tissues against the deleterious effects of free radicals (Liu et al., 2018;Naderi et al., 2019;Wang et al., 2019). Besides, VE can increase antioxidant ability of fish by enhancing the antioxidant enzyme activities containing superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px), such as largemouth bass (Micropterus salmoides) (Li et al., 2018), hybrid snakehead (Channa argus × Channa maculata)

Although immune dysfunction has been investigated in adult septic patients, early immune status remains unclear. In this study, our primary aim was to assess early immune status in adult patients with sepsis stratified by age and its relevance to hospital mortality. Patients and Methods: A post hoc analysis of a multicenter, randomized controlled trial was conducted; 273 patients whose immune status was evaluated within 48 hours after onset of sepsis were enrolled. Early immune status was evaluated by the percentage of monocyte human leukocyte antigen-DR (mHLA-DR) in total monocytes within 48 hours after onset of sepsis and it was classified as immunoparalysis (mHLA-DR ≤30%) or non-immunoparalysis (>30%). Three logistic regression models were conducted to explore the associations between early immunoparalysis and hospital mortality. We also developed two sensitivity analyses to find out whether the definition of early immune status (24 hours vs 48 hours after onset of sepsis) and immunotherapy affect the primary outcome. Results: Of the 181 elderly (≥60yrs) and 92 non-elderly (<60yrs) septic patients, 71 (39.2%) and 25 (27.2%) died in hospital, respectively. The percentage of early immunoparalysis in the elderly was twice of that in the non-elderly patients (32% vs 16%, p=0.006). For the elderly, hospital mortality was higher in the immunoparalysis ones than the nonimmunoparalysis ones (53.4% vs 32.5%, p=0.009). But there was no significant difference in hospital mortality between immunoparalysis non-elderly patients and nonimmunoparalysis non-elderly ones (33.5% vs 26.0%, p=0.541). By means of logistic regression models, we found that early immunoparalysis was independently associated with increased hospital mortality in elderly, but not in non-elderly patients. Sensitivity analysis further confirmed the definition of early immune status and immunotherapy did not affect the outcomes. Conclusion:The elderly were more susceptible to early immunoparalysis after onset of sepsis. Early immunoparalysis was independently associated with poor prognosis in elderly, but not in non-elderly patients.