Role of Early Immune Replacement Therapy in Reducing the Rate of Nosocomial Pneumonia in Severe Polytrauma

Abstract

Цель исследования. Оценка эффективности ранней иммунозаместительной терапии у пострадавших с тяжелой соче танной травмой (ТСТ).Objective: to evaluate the efficiency of early immune replacement therapy (EIRT) in patients with severe polytrauma (SCI). Subjects and methods. Two hundred and twenty five victims aged 35.5±14.1 years with SCI (ISS>30 scores), includ ing 158 cases of nosocomial pneumonia, were examined. According to the use of EIRT with donor immunoglobulin (IgG) (daily within the first three days), the patients were divided into two groups: 1) standard intensive treatment was added by EIRT (n=126) and 2) that without EIRT (n=99). Immunological examination was performed on days 1, 3, 6, and 9 after injury. The investigators determined the relative and absolute counts of major lymphocyte populations: T (CD3 + ) and B (CD19 + ) lymphocytes, those of T cell populations: (CD4 + ) helper T cells and (CD8 + ) cytotoxic T lymphocytes, the con centrations of the immunoglobulins A, O, and M classes (IgA, IgG and IgM), neutrophil absorptive and bactericidal activ ities, and the serum levels of large, middle, and small circulating immune complexes, C reactive protein, and procalcitonin. The incidence of nosocomial pneumonia and sepsis and the outcome of injury were analyzed in both groups. Results. The performed investigation indicated that EIRT in Group 1 victims resulted in a 27.6% decline in the number of patients who