Polymorphonuclear neutrophil chemiluminescence in whole blood from blunt trauma patients with multiple injuries

Background: Studies using isolated polymorphonuclear neutrophils (PMNs) ind icate that trauma is associated with altered function of PMNs, Because isol ation of PMNs can itself alter the function of these cells, we examined the relationships among measures of injury severity and several indices of PMN function using whole blood samples from trauma patients. Methods: Whole blood samples were obtained from 12 blunt trauma patients wi th multiple injuries in the intensive care unit of a Level I trauma center within 24 hours of admission and from 11 healthy volunteers. Samples were a ssayed for PMN chemiluminescence (CL) in response to a complement receptor 3 (CR3)-dependent agonist and for CD11b (CR3) expression. Common clinical p arameters were correlated with CL and CR3 expression. Results: The CL ratio (i.e. unprimed/primed CL) was significantly correlate d with initial base deficit (BD), Injury Severity Score (ISS), CR3 expressi on, units of packed red blood cells transfused during the interval before b lood sampling, and length of intensive care unit stay (survivors only). In contrast, ED did not correlate with units of red blood cells transfused or length of stay. Similarly, ISS did not correlate with length of stay. Conclusion: Significant correlations were observed between CL ratios and CR 3 expression, ISS, initial ED, length of stay, and units of blood given, Th ese data suggest that measuring CL produced by PMNs in whole blood is a pot entially useful way to assess injury severity. Whereas the initial ED and I SS are indicators of how badly injured a patient is at the time of entry in to a trauma center, the CL ratio may be a more useful indicator of both inj ury severity and prognosis.