Evolution of the Lymphocyte Phenotype in Patients With Infection in Intensive Care Unit

University Hospital, Brest38 enrolled

Overview

Patients admitted for polytrauma, severe neurological injury, post-operative monitoring or sepsis/septic shock present with significant inflammation, leading to immunoparalysis, which is responsible for infection, particularly prolonged infection. A study of their lymphocyte phenotype over time could help explore the phenomenon of immunoparalysis.

Study Type

INTERVENTIONAL

Allocation

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

Conditions

Patients Undergoing Esophagectomy Patients With Severe Polytrauma Patients With Severe Neurological Lesion Patients With Abdominal Infection

Interventions

Lymphocyte Phenotyping ProcedurePROCEDURE

For all patients, lymphocyte phenotyping will be performed on biological samples taken on D0, D7 and the day of discharge. In case of infection, phenotyping will also be performed on the day of infection diagnosis and on the day corresponding to half the duration of antibiotic therapy. For phenotyping, only 1.5 mL will be used. In case of infection, an additional 1mL will be collected (0.5mL on the day of inclusion diagnosis and 0.5 mL on the day corresponding to half the duration of antibiotic therapy). Blood is collected during sampling, which takes place several times a day as part of the standard management of these patients. It is important to note that phenotyping is not routinely performed as part of routine care. An additional tube is therefore taken specifically for this analysis, but this is done without the need for an additional puncture.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria: * Postoperative esophagectomy surveillance within the last 24 hours. * Patients with intra-abdominal infection * Neurological patients with intubation planned for more than 24 hours (subarachnoid hemorrhage with coma, severe head trauma, ischemic or hemorrhagic stroke with coma). * Polytrauma with intubation planned for more than 24 hours * Patient aged 18 and over * Patient with social security coverage Non-inclusion criteria : * Hereditary immune deficiency HIV-AIDS * Malignant hemopathies * Immunosuppressive treatment other than corticosteroid therapy or chemotherapy * Patient under legal protection * Pregnant or breast-feeding women

Locations (1)

CHU de Brest

Brest, France

Outcomes

Primary Outcomes

Lymphocytes numbers variation

\- Numbers of various lymphocytes (LT, LB, NK and their subclasses) at D0 according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury)

Time frame: Day 0

Lymphocytes numbers variation

\- Numbers of various lymphocytes (LT, LB, NK and their subclasses) at D7 according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury)

Time frame: Day 7

Lymphocytes numbers variation

\- Numbers of various lymphocytes (LT, LB, NK and their subclasses) at discharge according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury)

Time frame: Immediately upon prescribed discharge date

Lymphocytes numbers variation

\- Numbers of various lymphocytes (LT, LB, NK and their subclasses) at diagnosis of infection according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury)

Time frame: Immediately after diagnosis of infection

Lymphocytes numbers variation

\- Numbers of various lymphocytes (LT, LB, NK and their subclasses) at half duration of infection's treatment according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury)

Time frame: At the midpoint of the prescribed antibiotic course

Lymphocytes percentages variation

\- Percentage rate of various lymphocytes (LT, LB, NK and their subclasses) at D0 according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury)

Time frame: Day 0

Data from ClinicalTrials.gov

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Secondary Outcomes

Lymphocytes percentages variation in case of infection

Percentage rate in various lymphocytes (LT, LB, NK and their subclasses) at D0

Time frame: Day 0

Lymphocytes percentages variation in case of infection

Percentage rate in various lymphocytes (LT, LB, NK and their subclasses) at onset of infection

Time frame: At the onset of symptoms of infection

Lymphocytes percentages variation in case of infection

Percentage rate in various lymphocytes (LT, LB, NK and their subclasses) at resolution of infection

Time frame: Immediately following resolution of infection

Lymphocytes numbers variation in case of infection

Numbers rate in various lymphocytes (LT, LB, NK and their subclasses) at D0

Time frame: Day 0

Lymphocytes numbers variation in case of infection

Numbers rate in various lymphocytes (LT, LB, NK and their subclasses) at onset of infection

Time frame: Immediately after diagnosis of infection

Lymphocytes numbers variation in case of infection

Numbers rate in various lymphocytes (LT, LB, NK and their subclasses) at resolution of infection

Time frame: Immediately following resolution of infection