IN-VITRO GLYCOLYSIS OF WHOLE-BLOOD CAN DETECT PRIMED NEUTROPHILS IN SEPTIC ICU PATIENTS

The purpose of this study was to develop a bedside assay based on the in vitro glycolysis of a whole blood sample that could detect primed n eutrophils (PMNs). A mathematical index of the PMN response to exogeno us stimulation with phorbol myristate 13-acetate (PMA), called the Del ta value, was derived by comparing the increase in glycolysis for pair ed blood samples with and without PMA to that expected from normal sub jects. Delta values for systemic inflammatory response syndrome/sepsis patients (9.09 +/- 7.61) (N = 36) were significantly higher than norm al controls (2.02 +/- 1.76) (N = 51), nonsepsis ICU patients (3.81 +/- 2.80) (N = 14) and patients in septic shock (2.33 +/- 3.04) (N = 10) (p < .05). Delta values were consistently reflected in parallel measur ements of increased reactive oxygen species production by neutrophils detected cytofluorometrically. PMN priming can be simply and rapidly d etected by an assay based on the numbers of PMNs and erythrocytes and the measured rates of in vitro glycolysis of paired whole blood sample s with and without PMA.