Comparison between in vitro lymphocyte activity and metabolic changes in trauma patients.

This study was designed to investigate the relationship of in vitro and in vivo components of host immunocompetence and various biochemical parameters of injury. Thirteen multiple trauma victims were evaluated within 2 to 3 days postinjury while maintained on 5% glucose. The mean nitrogen balance of the patients was -18 gm/24 hr and the resting metabolic expenditure was increased 22.3%. Seventy-five per cent of the patients skin tested were anergic or relatively anergic. Patient lymphocyte response to the T cell mitogens phytohemagglutinin and concanavalin A were suppressed 45 and 48%, respectively, when compared to 24 normal healthy individuals. Total lymphocyte count (1,558) and percentage of T lymphocytes (63%) were within normal limits. The suppression of lymphocyte response to mitogens correlated by regression analysis with the negative nitrogen balances and resting metabolic expenditures in these patients (p less than 0.05). The depression of lymphocyte activity can be correlated with the catabolic response of injury in multiple trauma patients.