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Expansion of CD14+CD16+Monocytes in Critically Ill Cardiac Surgery Patients

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Abstract

We have asked whether critically ill cardiac valve surgery patients identified by a high APACHE II score exhibit an increase in the number of proin-flammatory CD14+ CD16+ monocytes. A group of 12 patients was studied over a period of 5 days post cardiac valve surgery for changes in blood monocyte populations. Patients were selected on day 1 post surgery to either be in good clinical condition (APACHE II Score of ≤14; N = 9) or to be critically ill (APACHE II score of ≥24; N = 3). The ≤14 patients had an uneventful course and could leave the ICU after 2–3 days. Among the ≥24 patients two showed a decrease of the score to ≤14 within the 5 days of observation and they could leave the ICU thereafter. One ≥24 patient (patient #2) had a persistently high score and finally died on day 28. Analysis of blood monocytes on day 1 post surgery revealed that the ≤14 patients had normal values of CD14+CD16+ monocytes (44 ± 9/μl). By contrast the ≥24 patients had increased values of these cells with 243 ± 106 cells per μ1 on day 1. The numbers of CD14+CD16+ monocytes returned to the control range over the 5 days of observation in 2 of the ≥24 patients concomitant with the improvement of the APACHE II score. CD14+CD16+ monocytes remained, however, at a high level in patient #2, the patient with persistently high APACHE II score.

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Author notes

  1. Günter Fingerle-Rowson

    Present address: The Picower Institute for Medical Research, Manhasset, New York

Authors and Affiliations

  1. Department of Internal Medicine I, Klinikum Grosshadern, University of Muenchen, Muenchen, FRG

    Günter Fingerle-Rowson & Jens Auers

  2. Department of Cardiac Surgery, Klinikum Grosshadern, University of Muenchen, Muenchen, FRG

    Eckhart Kreuzer

  3. Department of Clinical Chemistry, Klinikum Grosshadern, University of Muenchen, Muenchen, FRG

    Peter Fraunberger

  4. Stiftsklinik Augustinum, Muenchen, FRG

    Matthias Blumenstein

  5. Institute for Immunology, University of Muenchen, Muenchen, FRG.

    Loems H. W. Zeegler-Heitbrock

  6. LHW2H, Institute for Immunology, Goethestr., 80336, Muenchen, Germany

    Loems H. W. Zeegler-Heitbrock

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  1. Günter Fingerle-Rowson
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  6. Loems H. W. Zeegler-Heitbrock
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Fingerle-Rowson, G., Auers, J., Kreuzer, E. et al. Expansion of CD14+CD16+Monocytes in Critically Ill Cardiac Surgery Patients. Inflammation 22, 367–379 (1998). https://doi.org/10.1023/A:1022316815196

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