Predictive value for survival of lymphocytes and polymorphonuclear leukocytes in patients with sepsis.

To study their value in predicting prognosis, tests were performed on peripheral blood lymphomononuclear cells and polymorphonuclear leukocytes in 34 critically ill patients with sepsis. Intially, the number of lymphomononuclear cells was reduced by 32% compared with healthy control subjects and was 42% lower in those who died than in survivors. The values remained low in those who died. The numbers of T and B cells, determined by rosette formation using sheep and mouse erythrocytes, did not change during the period of observation. Intially, K cell activity was decreased by 48% compared with normal activity. In those younger than 65 years, K cell activity was 68% lower in patients who later died than in survivors. It returned to normal at 20 to 30 days and decreased in those who died. Polymorphonuclear leukocyte adherence was decreased by 50% compared with healthy control subjects and tended to be lower in those who died. Chemotactic migration of polymorphonuclear leukocytes and intracellular killing of Staphylococcus aureus and Pseudomonas aeruginosa were not impaired. It was concluded that the lymphomononuclear cell count, K cell activity and adherence of polymorphonuclear leukocytes were decreased in patients with sepsis and that the values were useful in predicting prognosis.