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Étude exploratoire sans calcul d'effectif (80 fixé arbitrairement, littérature absente). 38/80 inclus, suffisant pour de l'exploratoire. Données de bonne qualité malgré la difficulté des prélèvements à J0.
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Patients admitted for polytrauma, severe neurological injury, post-operative monitoring or sepsis/septic shock present with significant inflammation, leading to immunoparalysis, which is responsible for infection, particularly prolonged infection. A study of their lymphocyte phenotype over time could help explore the phenomenon of immunoparalysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phenotyping arm | Other | There is only one arm in the study. All patients (i.e. our 4 target populations) will undergo the same phenotyping procedure. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lymphocyte Phenotyping Procedure | Procedure | For all patients, lymphocyte phenotyping will be performed on biological samples taken on D0, D7 and the day of discharge. In case of infection, phenotyping will also be performed on the day of infection diagnosis and on the day corresponding to half the duration of antibiotic therapy. For phenotyping, only 1.5 mL will be used. In case of infection, an additional 1mL will be collected (0.5mL on the day of inclusion diagnosis and 0.5 mL on the day corresponding to half the duration of antibiotic therapy). Blood is collected during sampling, which takes place several times a day as part of the standard management of these patients. It is important to note that phenotyping is not routinely performed as part of routine care. An additional tube is therefore taken specifically for this analysis, but this is done without the need for an additional puncture. |
| Measure | Description | Time Frame |
|---|---|---|
| Lymphocytes numbers variation | - Numbers of various lymphocytes (LT, LB, NK and their subclasses) at D0 according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | Day 0 |
| Lymphocytes numbers variation | - Numbers of various lymphocytes (LT, LB, NK and their subclasses) at D7 according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | Day 7 |
| Lymphocytes numbers variation | - Numbers of various lymphocytes (LT, LB, NK and their subclasses) at discharge according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | Immediately upon prescribed discharge date |
| Lymphocytes numbers variation | - Numbers of various lymphocytes (LT, LB, NK and their subclasses) at diagnosis of infection according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | Immediately after diagnosis of infection |
| Lymphocytes numbers variation | - Numbers of various lymphocytes (LT, LB, NK and their subclasses) at half duration of infection's treatment according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | At the midpoint of the prescribed antibiotic course |
| Lymphocytes percentages variation | - Percentage rate of various lymphocytes (LT, LB, NK and their subclasses) at D0 according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) |
| Measure | Description | Time Frame |
|---|---|---|
| Lymphocytes percentages variation in case of infection | Percentage rate in various lymphocytes (LT, LB, NK and their subclasses) at D0 | Day 0 |
| Lymphocytes percentages variation in case of infection |
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Inclusion criteria:
Non-inclusion criteria :
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Brest | Brest | 29609 | France |
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For all patients, lymphocyte phenotyping will be performed on biological samples taken on D0, D7 and the day of discharge. In case of infection, phenotyping will also be performed on the day of infection diagnosis and on the day corresponding to half the duration of antibiotic therapy.
For phenotyping, only 1.5 mL (0.5 mL per analysis) will be used (if no infection). In case of infection, an additional 1mL will be collected (0.5mL on the day of inclusion diagnosis and 0.5 mL on the day corresponding to half the duration of antibiotic therapy). Blood is collected during sampling, which takes place several times a day as part of the standard management of these patients.
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| Day 0 |
| Lymphocytes percentages variation | - Percentage rate of various lymphocytes (LT, LB, NK and their subclasses) at D7 according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | Day 7 |
| Lymphocytes percentages variation | - Percentage rate of various lymphocytes (LT, LB, NK and their subclasses) at discharge according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | Immediately upon prescribed discharge date |
| Lymphocytes percentages variation | - Percentage rate of various lymphocytes (LT, LB, NK and their subclasses) at day of diagnosis according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | Immediately after diagnosis of infection |
| Lymphocytes percentages variation | - Percentage rate of various lymphocytes (LT, LB, NK and their subclasses) at half duration of infection's treatment according to reason for admission (postoperative vs sepsis/septic shock vs polytrauma vs neurological injury) | At the midpoint of the prescribed antibiotic course |
Percentage rate in various lymphocytes (LT, LB, NK and their subclasses) at onset of infection
| At the onset of symptoms of infection |
| Lymphocytes percentages variation in case of infection | Percentage rate in various lymphocytes (LT, LB, NK and their subclasses) at resolution of infection | Immediately following resolution of infection |
| Lymphocytes numbers variation in case of infection | Numbers rate in various lymphocytes (LT, LB, NK and their subclasses) at D0 | Day 0 |
| Lymphocytes numbers variation in case of infection | Numbers rate in various lymphocytes (LT, LB, NK and their subclasses) at onset of infection | Immediately after diagnosis of infection |
| Lymphocytes numbers variation in case of infection | Numbers rate in various lymphocytes (LT, LB, NK and their subclasses) at resolution of infection | Immediately following resolution of infection |