Background Patients often develop infectious complications after severe trauma. No biomarkers exist that enable early identification of patients who are at risk. Neutrophils are important immune cells that combat these infections by phagocytosis and killing of pathogens. Analysis of neutrophil function used to be laborious and was therefore not applicable in routine diagnostics. Hence, we developed a quick and point-of-care method to assess a critical part of neutrophil function, neutrophil phagosomal acidification. The aim of this study was to investigate whether this method was able to analyze neutrophil functionality in severely injured patients and whether a relation with the development of infectious complications was present. Results Fifteen severely injured patients (median ISS of 33) were included, of whom 6 developed an infection between day 4 and day 9 after trauma. The injury severity score did not significantly differ between patients who developed an infection and patients who did not ( p = 0.529). Patients who developed an infection showed increased acidification immediately after trauma ( p = 0.006) and after 3 days ( p = 0.026) and a decrease in the days thereafter to levels in the lower normal range. In contrast, patients who did not develop infectious complications showed high-normal acidification within the first days and increased tasset to identify patients at risk for infections after trauma and to monitor the inflammatory state of these trauma patients. Conclusion Neutrophil function can be measured in the ICU setting by rapid point-of-care analysis of phagosomal acidification. This analysis differed between trauma patients who developed infectious complications and trauma patients who did not. Therefore, this assay might prove a valuable asset to identify patients at risk for infections after trauma and to monitor the inflammatory state of these trauma patients. Trial registration Central Committee on Research Involving Human Subjects, NL43279.041.13. Registered 14 February 2014. https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm .

中文翻译：

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新的自动化分析可监测创伤后重症监护病房中中性粒细胞功能的现场护理

背景 严重创伤后患者经常出现感染性并发症。不存在能够及早识别处于危险中的患者的生物标志物。中性粒细胞是重要的免疫细胞，通过吞噬作用和杀死病原体来对抗这些感染。中性粒细胞功能的分析过去很费力，因此不适用于常规诊断。因此，我们开发了一种快速的即时护理方法来评估中性粒细胞功能的关键部分，即中性粒细胞吞噬体酸化。本研究的目的是调查该方法是否能够分析严重受伤患者的中性粒细胞功能以及是否与感染并发症的发展存在关系。结果 15 名重伤患者（中位 ISS 为 33）被纳入研究，其中 6 名患者在创伤后第 4 天至第 9 天之间出现感染。发生感染的患者和未发生感染的患者的损伤严重程度评分没有显着差异 (p = 0.529)。发生感染的患者在创伤后立即 (p = 0.006) 和 3 天后 (p = 0.026) 表现出酸化增加，此后几天酸化减少至正常范围较低的水平。相比之下，未出现感染性并发症的患者在最初几天内表现出正常高酸化，并增加了tasset，以识别创伤后有感染风险的患者并监测这些创伤患者的炎症状态。结论 可以在 ICU 环境中通过吞噬体酸化的快速护理点分析来测量中性粒细胞功能。该分析在出现感染性并发症的创伤患者和未出现感染性并发症的创伤患者之间存在差异。因此，这种测定可能被证明是一种宝贵的资产，可以识别创伤后有感染风险的患者并监测这些创伤患者的炎症状态。试验注册中央人类受试者研究委员会，NL43279.041.13。2014 年 2 月 14 日注册。 https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm 。