Observational studyShock (Augusta, Ga.)2014
Innate immune function predicts the development of nosocomial infection in critically injured children.
Observational study in Shock (Augusta, Ga.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 citations in OpenAlex.
- Immune System Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference.Pediatrics · 2022Pooled it
- Pediatric Sepsis: Evolving Subphenotypes, Overlap Syndromes, and the Path to Precision Therapies.Clinics in chest medicine · 2026Review
- Reversibility of Immune Dysfunction Following Pediatric Thermal Injury.Journal of burn care & research : official publication of the American Burn Association · 2026Article
- Immune function in paediatric trauma patients: a prospective explorative cohort study.Frontiers in immunology · 2026Article
- Perioperative Blood Transfusion and Infectious Complications Among Pediatric Patients with Cancer.Children (Basel, Switzerland) · 2025Article
- Article
- The role of myeloid-derived suppressor cells in children.Frontiers in pediatrics · 2025Review
- Granulocyte- Macrophage Colony-Stimulating Factor Reverses Immunosuppression Acutely Following a Traumatic Brain Injury and Hemorrhage Polytrauma in a Juvenile Male Rat Model.Journal of neurotrauma · 2024Article
- New findings on CD16Frontiers in immunology · 2024Observational
- Comparison of whole blood cytokine immunoassays for rapid, functional immune phenotyping in critically ill patients with sepsis.Intensive care medicine experimental · 2023Article
- Whey protein hydrolysate mitigates both inflammation and endotoxin tolerance in THP-1 human monocytic leukemia cells.Immunity, inflammation and disease · 2022Article
- Measures of Adaptive Immune Function Predict the Risk of Nosocomial Infection in Pediatric Burn Patients.Journal of burn care & research : official publication of the American Burn Association · 2022Observational
- Regulation of Key Immune-Related Genes in the Heart Following Burn Injury.Journal of personalized medicine · 2022Article
- Mild-to-severe traumatic brain injury in children: altered cytokines reflect severity.Journal of neuroinflammation · 2022Article
- Central nervous system injury-induced immune suppression.Neurosurgical focus · 2022Review
- Differences in the Genomic Profiles of Immunoparalyzed and Nonimmunoparalyzed Children With Sepsis: A Pilot Study.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2022Observational
- Early detection of soluble CD27, BTLA, and TIM-3 predicts the development of nosocomial infection in pediatric burn patients.Frontiers in immunology · 2022Observational
- The role of macrophages in thermal injury.International journal of burns and trauma · 2022Review
- Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries-Insights from the REALISM Study.Journal of clinical medicine · 2021Article
- Immune Function following Major Spinal Surgery and General Anesthesia.Journal of pediatric intensive care · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundCritical injury has been associated with reduction in innate immune function in adults, with infection risk being related to degree of immune suppression. This relationship has not been reported in critically injured children. HYPOTHESIS: Innate immune function will be reduced in critically injured children, and the degree of reduction will predict the subsequent development of nosocomial infection.
methodsChildren (≤18 years old) were enrolled in this longitudinal, prospective, observational, single-center study after admission to the pediatric intensive care unit following critical injury, along with a cohort of outpatient controls. Serial blood sampling was performed to evaluate plasma cytokine levels and innate immune function as measured by ex vivo lipopolysaccharide-induced tumor necrosis factor α (TNF-α) production capacity.
resultsSeventy-six critically injured children (and 21 outpatient controls) were enrolled. Sixteen critically injured subjects developed nosocomial infection. Those subjects had higher plasma interleukin 6 and interleukin 10 levels on posttrauma days 1-2 compared with those who recovered without infection and outpatient controls. Ex vivo lipopolysaccharide-induced TNF-α production capacity was lower on posttrauma days 1-2 (P = 0.006) and over the first week following injury (P = 0.04) in those who went on to develop infection. A TNF-α response of less than 520 pg/mL at any time in the first week after injury was highly associated with infection risk by univariate and multivariate analysis. Among transfused children, longer red blood cell storage age, not transfusion volume, was associated with lower innate immune function (P < 0.0001). Trauma-induced innate immune suppression was reversible ex vivo via coculture of whole blood with granulocyte-macrophage colony-stimulating factor.
conclusionsTrauma-induced innate immune suppression is common in critically injured children and is associated with increased risks for the development of nosocomial infection. Potential exacerbating factors, including red blood cell transfusion, and potential therapies for pediatric trauma-induced innate immune suppression are deserving of further study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.