Autonomic nervous system activity and the risk of nosocomial infection in critically ill patients with brain injury

Purpose Nosocomial infection contributes to adverse outcome after brain injury. This study investigates whether autonomic nervous system activity is associated with a decreased host immune response in patients following stroke or traumatic brain injury (TBI). Methods A prospective study was performe...

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Published in:Intensive care medicine experimental 2020-11, Vol.8 (1), p.69-69, Article 69
Main Authors: Wirtz, Mathijs R., Moekotte, Jiri, Balvers, Kirsten, Admiraal, Marjolein M., Pittet, Jean-Francois, Colombo, Joe, Wagener, Brant M., Goslings, J. Carel, Juffermans, Nicole
Format: Article
Language:English
Subjects:
Critical care
Critical Care Medicine
Immune system
Intensive
Medicine
Medicine & Public Health
Nervous system
Nosocomial infections
Traumatic brain injury
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Summary:Purpose Nosocomial infection contributes to adverse outcome after brain injury. This study investigates whether autonomic nervous system activity is associated with a decreased host immune response in patients following stroke or traumatic brain injury (TBI). Methods A prospective study was performed in adult patients with TBI or stroke who were admitted to the Intensive Care Unit of our tertiary university hospital between 2013 and 2016. Heart rate variability (HRV) was recorded daily and assessed for autonomic nervous system activity. Outcomes were nosocomial infections and immunosuppression, which was assessed ex vivo using whole blood stimulations with plasma of patients with infections, matched non-infected patients and healthy controls. Results Out of 64 brain injured patients, 23 (36%) developed an infection during their hospital stay. The ability of brain injured patients to generate a host response to the bacterial endotoxin lipopolysaccharides (LPS) was diminished compared to healthy controls ( p  
ISSN:2197-425X
2197-425X
DOI:10.1186/s40635-020-00359-3