HLA-DR expression in neonates after cardiac surgery under cardiopulmonary bypass: a pilot study

Abstract

Monocyte HLA-DR expression has been reported as a marker of immunosuppression and a predictor of sepsis development. However, to date, there is no report on monocyte HLA-DR monitoring exclusively in neonates (< 28 days of life) who underwent cardiac surgery under cardiopulmonary bypass (CPB), which have a high risk of nosocomial infection. In this pilot study, we studied nine neonates with a diagnosis of congenital heart disease requiring surgery under CPB. There was a significant reduction in monocyte HLA-DR expression for the first two postoperative days, as compared to preoperatively (p = 0.004). Moreover, neonates who displayed an episode of NI had a dramatically lower HLA-DR expression at day 4, as compared to neonates without NI (4257 AB/c [2220–5895] vs 14,947 AB/c [9858–16,960]; p = 0.04). Our preliminary results could indicate that HLA-DR expression may be a useful biomarker of immunosuppression-induced secondary infection after CPB in neonates.

Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study

“…It can reflect net sum of pro-and anti-inflammatory process during sepsis [14]. Lower expression level is associated with immunosuppression and higher risk of secondary infection [15][16][17][18].…”

Automated closed-loop management of body temperature using forced-air blankets: preliminary feasibility study in a porcine model

“…Animal preparation was performed as in previous and related studies [ 19 ]. The animals were housed on straw in a 6 m 2 cage, were fed with standard diet and had free access to water.…”

“…Given this broad range of closed-loop control applications, the presented TTM system is itself part of an extended ICU automation system, using closed-loop control for various vital parameters to maintain homeostasis in a porcine model [ 19 ] and evaluating the automation of different detection algorithms such as for the detection of blood withdrawal by characteristic changes in vital parameters [ 20 ].…”

Induced immunosuppression in critical care: diagnostic opportunities in clinical practice

“…Этот биомаркер является самым популярным параметром в мониторинге иммуносупрессии при различных критических состояниях. В клинических исследованиях величина и длительность персистенции снижения HLA-DR на моно-цитах коррелируют с увеличением смертности и частоты возникновения инфекций [23], связанных с оказанием медицинской помощи (ИСОМП) у пациентов отделения реанимации и интенсивной терапии (ОРИТ) [24]. Следует отметить, что у пациентов, перенесших кардиохирургическую операцию, мониторинг уровня ýкспрессии HLA-DR на моноцитах в течение первых суток после операции не позволяет прогнозировать повышенный риск послеоперационных SIRS, сепсиса или инфекционных осложнений.…”