IMMUNOLOGICAL MONITORING FOLLOWING SEVEREINJURY

Trauma, burn injury, and major surgery lead to severe suppression of t he immune system with an increased susceptibility to septic complicati ons. Therefore, the monitoring of essential immune functions in the ea rly and late post-traumatic course may permit trauma patients with an increased risk for infectious complications to be identified. Most fun ctions of the specific and nonspecific immune system can be determined with ELISA, RIA, or other immunological techniques. However, only a s mall number of these techniques demonstrate an acceptable sensitivity and specificity for infectious complications. Moreover, the techniques used in daily monitoring should be simple, reproducible and not expen sive with regard to materials. For immunological monitoring we suggest two scoring systems (ISS; APACHE II), biochemical parameters (elastas e, neopterin, CRP, lactate), and interleukin-6 plasma levels. The clin ical relevance of this monitoring must be proven in clinical studies.