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In vivo quantification of rolling and adhered leukocytes in human sepsis

BACKGROUND: The use of in vivo videomicroscopy at the bedside has demonstrated microcirculatory flow disturbances in sepsis. The ability of in vivo videomicroscopy to detect changes in the prevalence of rolling and adhered leukocytes that occur in sepsis is not well-described in humans. We sought to...

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Autores principales: Fabian-Jessing, Bjorn K., Massey, Michael J., Filbin, Michael R., Hou, Peter C., Wang, Henry E., Kirkegaard, Hans, Yealy, Donald M., Aird, William C., Kellum, John A., Angus, Derek C., Shapiro, Nathan I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164176/
https://www.ncbi.nlm.nih.gov/pubmed/30268146
http://dx.doi.org/10.1186/s13054-018-2173-z
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author Fabian-Jessing, Bjorn K.
Massey, Michael J.
Filbin, Michael R.
Hou, Peter C.
Wang, Henry E.
Kirkegaard, Hans
Yealy, Donald M.
Aird, William C.
Kellum, John A.
Angus, Derek C.
Shapiro, Nathan I.
author_facet Fabian-Jessing, Bjorn K.
Massey, Michael J.
Filbin, Michael R.
Hou, Peter C.
Wang, Henry E.
Kirkegaard, Hans
Yealy, Donald M.
Aird, William C.
Kellum, John A.
Angus, Derek C.
Shapiro, Nathan I.
author_sort Fabian-Jessing, Bjorn K.
collection PubMed
description BACKGROUND: The use of in vivo videomicroscopy at the bedside has demonstrated microcirculatory flow disturbances in sepsis. The ability of in vivo videomicroscopy to detect changes in the prevalence of rolling and adhered leukocytes that occur in sepsis is not well-described in humans. We sought to (1) develop methodology for accessing and quantifying sublingual leukocyte rolling and adherence with sidestream dark field (SDF) imaging; (2) compare the number of rolling and adhered leukocytes between patients with septic shock and non-infected controls; and (3) compare the number of rolling and adhered leukocytes between survivors and non-survivors of septic shock. METHODS: We included adult (age > 18 years) patients in the emergency department presenting with septic shock prospectively enrolled in the ProCESS trial. We recruited comparison non-infected patients as emergency department controls. Using a SDF videomicroscope, we obtained image sequences from the sublingual mucosa, quantifying rolling and adhered leukocytes per 1 mm × 1 mm visual field in a standardized 3-s clip. We report data as median and interquartile range and depicted as box plots. We compared groups using the Mann-Whitney U test, considering a p value < 0.05 significant. RESULTS: We included a total of 64 patients with septic shock and 32 non-infected controls. The median number of adhered leukocytes per field in the sepsis group was 1.0 (IQR 0–3.5) compared to 0 (0–0) in the non-infected group (p < 0.001). The median number of rolling leukocytes was 26 (10.3–42) in the sepsis group and 9.8 (4.8–17.3) in the non-infected group (p < 0.001) per field. Among the patients with sepsis (n = 64), there was an increased number of adhered leukocytes in non-survivors compared to survivors (3.0 (1–5.5) vs. 1.0 (0–3.0)) (p < 0.05); however, there was no difference in rolling leukocytes (35 (20–48) vs. 26 (10–41)) (p = 0.31). CONCLUSIONS: Our results demonstrated a higher number of rolling and adhered leukocytes in patients with septic shock when compared to non-infected controls, and an increased number of adhered leukocytes in non-survivors. TRIAL REGISTRATION: ClinicalTrials.gov, NCT00793442; Registered on 19 November 2008 PG0GM076659 (US NIH Grant/Contract). First submitted 18 July 2007. First posted 2 August 2007. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-018-2173-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-61641762018-10-10 In vivo quantification of rolling and adhered leukocytes in human sepsis Fabian-Jessing, Bjorn K. Massey, Michael J. Filbin, Michael R. Hou, Peter C. Wang, Henry E. Kirkegaard, Hans Yealy, Donald M. Aird, William C. Kellum, John A. Angus, Derek C. Shapiro, Nathan I. Crit Care Research BACKGROUND: The use of in vivo videomicroscopy at the bedside has demonstrated microcirculatory flow disturbances in sepsis. The ability of in vivo videomicroscopy to detect changes in the prevalence of rolling and adhered leukocytes that occur in sepsis is not well-described in humans. We sought to (1) develop methodology for accessing and quantifying sublingual leukocyte rolling and adherence with sidestream dark field (SDF) imaging; (2) compare the number of rolling and adhered leukocytes between patients with septic shock and non-infected controls; and (3) compare the number of rolling and adhered leukocytes between survivors and non-survivors of septic shock. METHODS: We included adult (age > 18 years) patients in the emergency department presenting with septic shock prospectively enrolled in the ProCESS trial. We recruited comparison non-infected patients as emergency department controls. Using a SDF videomicroscope, we obtained image sequences from the sublingual mucosa, quantifying rolling and adhered leukocytes per 1 mm × 1 mm visual field in a standardized 3-s clip. We report data as median and interquartile range and depicted as box plots. We compared groups using the Mann-Whitney U test, considering a p value < 0.05 significant. RESULTS: We included a total of 64 patients with septic shock and 32 non-infected controls. The median number of adhered leukocytes per field in the sepsis group was 1.0 (IQR 0–3.5) compared to 0 (0–0) in the non-infected group (p < 0.001). The median number of rolling leukocytes was 26 (10.3–42) in the sepsis group and 9.8 (4.8–17.3) in the non-infected group (p < 0.001) per field. Among the patients with sepsis (n = 64), there was an increased number of adhered leukocytes in non-survivors compared to survivors (3.0 (1–5.5) vs. 1.0 (0–3.0)) (p < 0.05); however, there was no difference in rolling leukocytes (35 (20–48) vs. 26 (10–41)) (p = 0.31). CONCLUSIONS: Our results demonstrated a higher number of rolling and adhered leukocytes in patients with septic shock when compared to non-infected controls, and an increased number of adhered leukocytes in non-survivors. TRIAL REGISTRATION: ClinicalTrials.gov, NCT00793442; Registered on 19 November 2008 PG0GM076659 (US NIH Grant/Contract). First submitted 18 July 2007. First posted 2 August 2007. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-018-2173-z) contains supplementary material, which is available to authorized users. BioMed Central 2018-09-30 /pmc/articles/PMC6164176/ /pubmed/30268146 http://dx.doi.org/10.1186/s13054-018-2173-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Fabian-Jessing, Bjorn K.
Massey, Michael J.
Filbin, Michael R.
Hou, Peter C.
Wang, Henry E.
Kirkegaard, Hans
Yealy, Donald M.
Aird, William C.
Kellum, John A.
Angus, Derek C.
Shapiro, Nathan I.
In vivo quantification of rolling and adhered leukocytes in human sepsis
title In vivo quantification of rolling and adhered leukocytes in human sepsis
title_full In vivo quantification of rolling and adhered leukocytes in human sepsis
title_fullStr In vivo quantification of rolling and adhered leukocytes in human sepsis
title_full_unstemmed In vivo quantification of rolling and adhered leukocytes in human sepsis
title_short In vivo quantification of rolling and adhered leukocytes in human sepsis
title_sort in vivo quantification of rolling and adhered leukocytes in human sepsis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164176/
https://www.ncbi.nlm.nih.gov/pubmed/30268146
http://dx.doi.org/10.1186/s13054-018-2173-z
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