Title :

Impact of ventilator-associated pneumonia on cerebrospinal fluid inflammation during immunosuppression after subarachnoid hemorrhage: a pilot study

Author(s) :

Coelembier, Clement [Auteur]
Hospices Civils de Lyon [HCL]
Venet, Fabienne [Auteur]
Hospices Civils de Lyon [HCL]
Demaret, Julie [Auteur]
Hospices Civils de Lyon [HCL]
Viel, Sebastien [Auteur]
Hospices Civils de Lyon [HCL]
Lehot, Jean-Jacques [Auteur]
Hospices Civils de Lyon [HCL]
Dailler, Frederic [Auteur]
Hospices Civils de Lyon [HCL]
Monneret, Guillaume [Auteur]
Hospices Civils de Lyon [HCL]
Lukaszewicz, Anne-Claire [Auteur]
Hospices Civils de Lyon [HCL]

Journal title :

Journal of Neurosurgical Anesthesiology

Abbreviated title :

J Neurosurg Anesthesiol

Publication date :

2020-10-16

ISSN :

1537-1921

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Brain injuries can cause systemic immunosuppression, which in turn can lead to infections that adversely affect the injured brain and worsen clinical outcomes. This study aimed to investigate whether systemic ...
Show more >BACKGROUND: Brain injuries can cause systemic immunosuppression, which in turn can lead to infections that adversely affect the injured brain and worsen clinical outcomes. This study aimed to investigate whether systemic infection, such as ventilator-associated pneumonia (VAP), induce intracranial inflammation in patients with subarachnoid hemorrhage (SAH). METHODS: This prospective, observational study included 16 adults with SAH treated in the neuro-intensive care unit. Three paired cerebrospinal fluid samples (obtained from an external ventricular drain) and peripheral blood samples were obtained on days 1 to 3, 4 to 5, and 6 to 7 after SAH onset. Cell counts, cell phenotypes (monocyte HLA-DR, T regulatory cells, lymphocytes, and neutrophils), and inflammatory mediator levels were monitored. RESULTS: Six patients developed VAP in the context of systemic immunosuppression demonstrated by a reduction in monocyte HLA-DR expression, lymphopenia, increased percentages of circulating T regulatory cells, and increased proportions of immature and immunosuppressive neutrophil subsets. During VAP, there was de novo recruitment of leukocytes into the cerebrospinal fluid, preferentially neutrophils, which exacerbated intracranial inflammation. CONCLUSIONS: VAP increased intracranial inflammatory responses in patients with SAH despite the occurrence of systemic immunosuppression. A better understanding of cell trafficking and their pleiotropic functions in brain injury is needed to define the optimal strategies for preventing infections in patients with SAH.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2021-07-06T12:45:01Z
2024-02-05T11:05:36Z