Immunoparalysis in critical ill patients and its association to nosocomial and opportunist infections. a preliminary study

Methods Prospective and observational study.We included patients older than 18 years old, admitted to ICU and undergoing mechanical ventilation, who have been presented an acute failure of unless two organs. At admission, and on day 3 and 7, we determined: -Immunophenotypic lymphocyte subpopulations (ILS) (T, B and NK), concentration of immunoglobulins in serum, and expression of HLA-DR on monocytes and FOXP3 on T cells. Mini-bronchoalveolar lavage for bacterial, viral and fungal culture, detection by polymerase chain reaction of cytomegalovirus, herpes simplex virus and Aspergillus spp, and determination of galactoman. Serum sample to detect immunoglobulins (IgM and IgG) against HSV and CMV, and quantitative measurement of CMV DNA.In those patients diagnosed and treated for nosocomial or opportunist infection, we evaluated the same variables, the day of infection and after 72 h. All results are expressed as the median with interquiartile. Statistical analysis was performed using the Mann-Withney U test or kruskall-Wallis analysis. Data will be processed with SPSS 16.0.