Chemiluminescence: comparison of whole blood with isolated polymorphonuclear leukocytes after major trauma.

INTRODUCTION

Neutrophil (PMN) mediated tissue injury is central to the development of post-traumatic ARDS/MOF. Changes in activity caused by PMN isolation may be avoided by studying respiratory burst activity using whole blood chemiluminescence (WBCL).

METHODS

WBCL and PMNCL were measured in 5 normal laboratory volunteers (NLV) and 9 patients sustaining major trauma, within 2 hours of admission. Receptor mediated (STZ) and independent (PMA) activating agents were used.

RESULTS

PMA activation confirmed significant priming both in WBCL and PMNCL after major trauma. With STZ, priming was confirmed in the WBCL study, but the trauma patient PMNCL showed no difference in response to those of NLV. Although the study population was small, those patients later developing ARDS demonstrated significantly greater STZ activated WBCL, 8 hours after admission.

CONCLUSION

PMN isolation alters behavior in vitro. This may lead to important differences of in vivo PMN function being obscured when studied in the laboratory setting. Further study of CL response and surface receptor expression is clearly warranted, both in WB and PMN preparations.