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Adrie C, Lugosi M, Sonneville R, et al. Persistent lymphopenia is a risk factor for ICU-acquired infections and for death in ICU patients with sustained hypotension at admission. Ann Intensive Care. 2017;7(1):30doi: 10.1186/s13613-017-0242-0.
Adrie, C., Lugosi, M., Sonneville, R., Souweine, B., Ruckly, S., Cartier, J. C., Garrouste-Orgeas, M., Schwebel, C., Timsit, J. F. (2017). Persistent lymphopenia is a risk factor for ICU-acquired infections and for death in ICU patients with sustained hypotension at admission. Annals of intensive care, 7(1), 30. https://doi.org/10.1186/s13613-017-0242-0
Adrie, Christophe, et al. "Persistent lymphopenia is a risk factor for ICU-acquired infections and for death in ICU patients with sustained hypotension at admission." Annals of intensive care vol. 7,1 (2017): 30. doi: https://doi.org/10.1186/s13613-017-0242-0
Adrie C, Lugosi M, Sonneville R, Souweine B, Ruckly S, Cartier JC, Garrouste-Orgeas M, Schwebel C, Timsit JF. Persistent lymphopenia is a risk factor for ICU-acquired infections and for death in ICU patients with sustained hypotension at admission. Ann Intensive Care. 2017 Dec;7(1):30. doi: 10.1186/s13613-017-0242-0. Epub 2017 Mar 17. PMID: 28303547; PMCID: PMC5355405.
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Ann Intensive Care. 2017 Dec;7(1):30. doi: 10.1186/s13613-017-0242-0. Epub 2017 Mar 17.

Persistent lymphopenia is a risk factor for ICU-acquired infections and for death in ICU patients with sustained hypotension at admission.

Annals of intensive care

Christophe Adrie, Maxime Lugosi, Romain Sonneville, Bertrand Souweine, Stéphane Ruckly, Jean-Charles Cartier, Maité Garrouste-Orgeas, Carole Schwebel, Jean-François Timsit,

Affiliations

  1. Physiology Department, Cochin University Hospital, AP-HP, Paris Descartes University, 27 rue du Faubourg Saint Jacques, 75014, Paris, France. [email protected].
  2. Polyvalent ICU, Delafontaine Hospital, Saint-Denis, France. [email protected].
  3. Medical ICU, Grenoble 1 University, Albert Michallon Hospital, Grenoble, France.
  4. Medical and Infectious Diseases ICU, Bichat University Hospital, AP-HP, Paris, France.
  5. Clermont-Ferrand University, Medical ICU, Gabriel Montpied Hospital, Clermont-Ferrand, France.
  6. UMR 1137 IAME Inserm- Paris Diderot University, 75018, Paris, France.
  7. Polyvalent ICU, St Joseph Hospital, Paris, France.

PMID: 28303547 PMCID: PMC5355405 DOI: 10.1186/s13613-017-0242-0

Abstract

BACKGROUND: Severely ill patients might develop an alteration of their immune system called post-aggressive immunosuppression. We sought to assess the risk of ICU-acquired infection and of mortality according to the absolute lymphocyte count at ICU admission and its changes over 3 days.

METHODS: Adults in ICU for at least 3 days with a shock or persistent low blood pressure were extracted from a French ICU database and included. We evaluated the impact of the absolute lymphocyte count at baseline and its change at day 3 on the incidence of ICU-acquired infection and on the 28-day mortality rate. We categorized lymphocytes in 4 groups: above 1.5 × 10

RESULTS: A total of 753 patients were included. The median lymphocyte count was 0.8 × 10

CONCLUSION: Lymphopenia at ICU admission and its persistence at day 3 were associated with an increased risk of ICU-acquired infection, while only persisting lymphopenia predicted increased 28-day mortality. The lymphocyte count at ICU admission and at day 3 could be used as a simple and reproductive marker of post-aggressive immunosuppression.

Keywords: Absolute lymphocyte count; ICU; Immunosuppression; Infection; Nosocomial; Shock; Survival

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