Effect of cardiopulmonary resuscitation-induced stress on cell-mediated immunity.

Functions of cell-mediated immunity were studied from 11 patients after cardiovascular resuscitation and from matched controls who were simultaneously under observation. The resuscitated patients were anergic to recall skin antigens (93% negative) as compared to the controls (62%) (p less than 0.01). The anergic state correlated with the outcome of the patients. Lymphocyte numbers did not differ between these groups, but the number of T cells was significantly decreased, and B cells and granulocytes was increased in resuscitated patients. Lymphocytes from resuscitated patients responded to mitogenic stimulation although the responses were lower than those of the controls. Decreased lymphocyte responses were partly due to serum factor(s) which were not attributable to serum cortisol concentration. In addition the findings favour a change in the compartmentalization of lymphocyte subsets resulting in increased number of suppressor cells and/or increased sensitivity of lymphocytes to suppressive humoral factor(s) in the circulation. The anergy in skin evidently represents the final outcome of the dysfunction of several arms of cell mediated immunity.