Lymphocytic Immune Response of Children After Thermal Burn Injury in Duhok Burn and Plastic Hospital, Iraq
Keywords:
Lymphocyte, Immune response, Burn, DuhokAbstract
Objective: To evaluate the immune response to pediatric thermal injury admitted to Duhok Burn and Plastic Surgery Hospital, Duhok, Iraq. Methods: 118 participants were recruited in this prospective cohort study. In this study, patients with thermal burns who were 18 years of age or younger and had at least 10% of their total body surface area burned were enrolled. The medical records were used to collect the patients' demographics, mechanism of burn, laboratory results, and outcomes. About 4 ml of blood samples were taken from each participant and collected in an EDTA tube at two time intervals (24 hours of burn and 72 hours or longer after burn). To determine whether a patient's total white blood cell count, neutrophils percentage, and lymphocyte percentage were normal or abnormal. Results: At the first day, (59%.4) patients had abnormal lymphocyte percentage, while (40.6%) patients had normal lymphocyte percentage. Nevertheless, this difference was not significant (p value 0.42). At the third day, (64.5%) of patients had abnormal lymphocyte percentage, while (35.5%) of patients had normal lymphocyte percentage, which was statistically not significant (p value 0.38). Conclusion: After three days in the hospital, the higher numbers of voluntaries showed no improvement. No significant correlation was found between normal and abnormal lymphocyte percentage between first and third day of burn. Further research is required by including all age groups with bigger sample size to study the whole immune response during thermal burn.
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References
Sparkes, B. G. (1997). Immunological responses
to thermal injury. Burns, 23(2), 106-113.
Cioffi W. G. (2001). What's new in burns and
metabolism. Journal of the American
College of Surgeons, 192(2), 241–254.
https://doi.org/10.1016/s1072-
(00)00795-x
Pruitt Jr BA, McManus AT, Kim SH,
Goodwin CW (1998). Burn
woundinfections: current status. World
J Surg;22: pp.135-45.
Sittig, K., & Deitch, E. A. (1988). Effect of
bacteremia on mortality after thermal injury.Archives of Surgery, 123(11), 1367-1370.
Saffle, J.R., Davis, B. and Williams, P. (1995)
Recent Outcomes in the Treatment of
Burn Injury in the United States: A Report
from the American Burn Association
Patient Registry. Journal of Burn Care &
Rehabilitation, 16, 219-232.
Branski, L. K., Al-Mousawi, A., Rivero, H.,
Jeschke, M. G., Sanford, A. P., & Herndon,
D. N. (2009). Emerging infections in burns.
Surgical infections, 10(5), 389-397.
Jewo, P. I., & Fadeyibi, I. O. (2015). Progress in
burns research: a review of advances in burn
pathophysiology. Annals of burns and fire
disasters, 28(2), 105.
Robertson, C. M., & Coopersmith, C. M. (2006).
The systemic inflammatory response syndrome.
Microbes and infection, 8(5), 1382–1389.
https://doi.org/10.1016/j.micinf.2005.12.016
Ward, A., Tawila, G. A., Sawsan, M. A., Gad,
M., & El-Muniary, M. M. (2008).
Improving the nutritive value of cottonseed
meal by adding iron on growing lambs diets.
World J. Agric. Sci, 4(5), 533-537.
Muszynski, J. A., Nofziger, R., Greathouse, K.,
Nateri, J., Hanson-Huber, L., Steele, L., ...
& Hall, M. W. (2014). Innate immune
function predicts the development of
nosocomial infection in critically injured
children. Shock, 42(4), 313-321.
Muszynski, J. A., Thakkar, R., & Hall, M. W.
(2016). Inflammation and innate immune
function in critical illness. Current opinion in
pediatrics,28(3),267–273.
https://doi.org/10.1097/MOP.000000000000
Heffernan, D. S., Monaghan, S. F., Thakkar, R.
K., Machan, J. T., Cioffi, W. G., & Ayala, A.
(2012). Failure to normalize lymphopenia
following trauma is associated with increased
mortality, independent of the leukocytosis
pattern. Critical care (London, England),
(1), R12. https://doi.org/10.1186/cc11157
Drewry, A. M., Samra, N., Skrupky, L. P., Fuller,
B. M., Compton, S. M., & Hotchkiss, R. S.
(2014). Persistent lymphopenia after diagnosis
of sepsis predicts mortality. Shock (Augusta,
Ga.), 42(5), 383–391.
https://doi.org/10.1097/SHK.00000000000002
Teodorczyk-Injeyan, J. A., CembrzynskaNowak, M., Lalani, S., Peters, W. J., &
Mills, G. B. (1995). Immune deficiency
following thermal trauma is associated
with apoptotic cell death. Journal of
clinical immunology, 15(6), 318–328.
https://doi.org/10.1007/BF01541322
Decker, D., Schondorf, M., Bidlingmaier, F.,
Hirner, A., & von Ruecker, A. A. (1996).
Surgical stress induces a shift in the type-
/type-2 T-helper cell balance, suggesting
down-regulation of cell-mediated and upregulation of antibody-mediated immunity
commensurate to the trauma. Surgery,
(3), 316–325.
https://doi.org/10.1016/s0039-
(96)80118-8
Monserrat, J., de Pablo, R., Diaz-Martín,
D., et al. (2013). Early alterations of B
cells in patients with septic shock. Critical
care (London, England), 17(3), R105.
https://doi.org/10.1186/cc12750
Thakkar, R. K., Diltz, Z., Drews, J. D.,
Wheeler, K. K., Shi, J., Devine, R., Fabia,
R., & Hall, M. (2018). Abnormal
lymphocyte response after pediatric
thermal injury is associated with adverse
outcomes. The Journal of surgical
research, 228, 221–227.
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