Abstract | OBJECTIVE: DESIGN: Prospective, multicenter, observational study. SETTING: PATIENTS: Patients ≤18 yrs old admitted to a PICU with community-acquired influenza infection. A control group of outpatient children was also evaluated. INTERVENTIONS: ICU patients underwent sampling within 72 hrs of ICU admission for measurement of a panel of 31 serum cytokine levels and quantification of whole blood ex vivo lipopolysaccharide-stimulated tumor necrosis factor-α production capacity using a standardized stimulation protocol. Outpatient control subjects also underwent measurement of tumor necrosis factor-α production capacity. MEASUREMENTS AND MAIN RESULTS: CONCLUSIONS: High serum levels of cytokines can coexist with marked innate immune suppression in children with critical influenza. Severe, early innate immune suppression is highly associated with both S. aureus coinfection and mortality in this population. Multicenter innate immune function testing is feasible and can identify these high-risk children.
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Authors | Mark W Hall, Susan M Geyer, Chao-Yu Guo, Angela Panoskaltsis-Mortari, Philippe Jouvet, Jill Ferdinands, David K Shay, Jyotsna Nateri, Kristin Greathouse, Ryan Sullivan, Tram Tran, Shannon Keisling, Adrienne G Randolph, Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network PICFlu Study Investigators |
Journal | Critical care medicine
(Crit Care Med)
Vol. 41
Issue 1
Pg. 224-36
(Jan 2013)
ISSN: 1530-0293 [Electronic] United States |
PMID | 23222256
(Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Biomarkers
- Chemokines
- Cytokines
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Topics |
- Adolescent
- Biomarkers
(blood)
- Case-Control Studies
- Chemokines
(blood)
- Child
- Child, Preschool
- Cytokines
(blood)
- Female
- Humans
- Immunity, Innate
- Infant
- Infant, Newborn
- Influenza, Human
(immunology, mortality)
- Intensive Care Units, Pediatric
- Logistic Models
- Male
- Multivariate Analysis
- Prospective Studies
- Risk Assessment
- United States
(epidemiology)
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