TY  - JOUR
U1  - Zeitschriftenartikel, wissenschaftlich - begutachtet (reviewed)
A1  - Menges, P.
A1  - Kessler, W.
A1  - Kloecker, C.
A1  - Feuerherd, M.
A1  - Gaubert, S.
A1  - Diedrich, S.
A1  - van der Linde, J.
A1  - Hegenbart, A.
A1  - Busemann, A.
A1  - Traeger, T.
A1  - Cziupka, K.
A1  - Heidecke, C.-D.
A1  - Maier, S.
T1  - Surgical Trauma and Postoperative Immune Dysfunction
JF  - European Surgical Research
N2  - Background: In postoperative sepsis, mortality is increased due to the surgically induced immune dysfunction. Further causes of this traumatic effect on the immune system include burn injuries and polytrauma, as well as endogenous traumata like stroke. Several animal models have been defined to analyse the characteristics of trauma-induced immune suppression. This article will correlate our results from animal studies and clinical observations with the recent literature on postoperative immune suppression. Methods: The previously described model of surgically induced immune dysfunction (SID) was performed in mice by laparotomy and manipulation of the small intestine in the antegrade direction. Blood samples were collected 6 and 72 h following SID to analyse the white blood cell count and corticosterone levels. To assess the postoperative immune status in humans, we analysed expression of HLA-DR on monocytes of 118 patients by flow cytometry prior to and 24, 48 and 72 h after surgery. Results: The postoperative immune suppression in our SID model is characterised by lymphocytopenia and significantly increased corticosterone levels in mice dependent on the degree of surgical trauma. This is comparable to the postoperative situation in humans: major and especially long-lasting surgery results in a significantly reduced expression of HLA-DR on circulating monocytes. Previous studies describe a similar situation following burn injury and endogenous trauma, i.e. stroke. Conclusions: We suggest the completion of our previously published sepsis classification due to the immune status at the onset of sepsis: type A as the spontaneously acquired sepsis and type B as sepsis in trauma-induced pre-existing immune suppression.
KW  - -
KW  - Immune system
KW  - Postoperative immune suppression
KW  - Trauma
KW  - Sepsis
UN  - https://nbn-resolving.org/urn:nbn:de:gbv:9-opus-31300
UR  - www.karger.com/esr
SN  - 0014-312X
SS  - 0014-312X
SN  - 1421-9921
SS  - 1421-9921
U6  - https://doi.org/10.1159/000338196
DO  - https://doi.org/10.1159/000338196
PM  - 22653168
VL  - 48
IS  - 4
SP  - 180
EP  - 186
PB  - S. Karger AG
CY  - Basel, Switzerland
ER  -