PEDIATRICS Vol. 93 No. 5 May 1994, pp. 807-809
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Depressed Neutrophil Chemotaxis in Children Suffering Blunt Trauma

Peter J. Krause MD1, Charles L. Woronick PhD1, Georgine Burke PhD1, Nadia Slover MT1, Catherine Kosciol BS1, Timothy Kelly MD1, Betty Spivack MD1, and Eufronio G. Maderazo MD1

1 Department of Pediatrics and Medicine, Hartford Hospital and The University of Connecticut School of Medicine, Hartford, CT

Objective. Impaired neutrophil (PMN) function, due in part to release of immature PMNs into the circulation, contributes to the increased rate of infection observed in adults suffering blunt trauma. The objective of this study was to determine whether similar events occur in children.

Methods. We assessed PMN chemotaxis and PMN maturation in 25 children (7 young children and 18 adolescents) and 25 adults 1 to 9 days after suffering blunt trauma, and in healthy adult control subjects. PMN chemotaxis was determined using a standard micropore filter assay, whereas PMN maturation was determined with 31D8, a novel monoclonal antibody that binds to mature PMNs more avidly than immature PMNs and band forms.

Results. In patients suffering blunt trauma, mean PMN chemotactic values were similar among children (44.6 ± 2.3 µm) and adults (41.3 ± 2.1 µm) and both were significantly less than among healthy adults (53.5 ± 2.4 µm, P < .0005). PMN chemotactic values increased significantly in the 9 days after trauma for both children and adults (F = 13.8, df = 1, P < .0002). Mean PMN 31D8 binding among children with trauma (92.5 ± 5.2) was significantly less than among healthy adults (117.6 ± 5.4, P < .0009).

Conclusions. Impairment in PMN chemotaxis occurs in children after blunt trauma and is due in part to release of immature PMNs into the circulation.

Submitted on July 19, 1993
Accepted on December 23, 1993




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