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Neutrophil kinetics and function after major trauma:A systematic review

World Journal of Critical Care Medicine 2021年第5期10卷 260-277页

作者： liam db finlay Andrew Conway Morris Adam M Deane Alexander JT Wood Melbourne Medical School University of MelbourneMelbourne 3052VictoriaAustralia Department of Medicine University of CambridgeCambridge 01223United Kingdom Centre for Integrated Critical Care University of MelbourneParkville 3052VictoriaAustralia Intensive Care Unit Royal Melbourne HospitalParkville 3052VictoriaAustralia

BACKGROUND Immune dysfunction following major traumatic injury is complex and strongly associated with significant morbidity and mortality through the development of multiple organ dysfunction syndrome(MODS),persistent inflammation,immunosuppression,and catabolism syndrome and *** are thought to be a pivotal mediator in the development of immune *** To provide a review with a systematic approach of the recent literature describing neutrophil kinetics and functional changes after major trauma in humans and discuss hypotheses as to the mechanisms of the observed neutrophil dysfunction in this *** Medline,Embase and PubMed were searched on January 15,*** were screened by two reviewers and those included had their reference list hand searched for additional papers of *** criteria were adults>18 years old,with an injury severity score>12 requiring admission to an intensive care *** that analysed major trauma patients as a subgroup were *** Of 107 papers screened,48 were included in the *** were heterogeneous and most studies had a moderate to significant risk of bias owing to their observational nature and small sample *** findings included a persistently elevated neutrophil count,stereotyped alterations in cell-surface markers of activation,and the elaboration of heterogeneous and immunosuppressive populations of cells in the *** of these changes correlate with clinical outcomes such as MODS and secondary *** phenotype remains a promising avenue for the development of predictive markers for immune *** Understanding of neutrophil phenotypes after traumatic injury is expanding.A greater emphasis on incorporating functional and clinically significant markers,greater uniformity in study design and assessment of extravasated neutrophils may facilitate risk stratification in patients affected by major trauma.

关键词： Neutrophils Multiple trauma Immunophenotypes Inflammation Systemic inflammatory response syndrome Intensive care units

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