Abstract
Introduction: Current surgical guidelines for the treatment of intra-abdominal sepsis recommend interventional source control as the key element of therapy, alongside resuscitation and antibiotic administration. Past trials attempted to predict the success of interventional source control to assess whether further interventional therapy is needed. However, no predictive score could be developed. Materials and methods: We utilized an established murine abdominal sepsis model, the cecal ligation and puncture (CLP), and performed a successful surgical source control interven-tion after full development of sepsis, the CLP-excision (CLP/E). We then sought to evaluate the success of the source control by characterizing circulating neutrophil phenotype and functionality 24 h postintervention. Results: We showed a significant relative increase of neutrophils and a significant absolute and relative increase of activated neutrophils in septic mice. Source control with CLP/E restored these numbers back to baseline. Moreover, main neutrophil functions, the acidi-fication of cell compartments, such as lysosomes, and the production of Tumor Necrosis Factor-alpha (TNF-a), were impaired in septic mice but restored after CLP/E intervention. Conclusions: Neutrophil characterization by phenotyping and evaluating their functionality indicates successful source control in septic mice and can serve as a prognostic tool. These findings provide a rationale for the phenotypic and functional characterization of neutro-phils in human patients with infection. Further studies will be needed to determine whether a predictive score for the assessment of successful surgical source control can be established. (c) 2022 Elsevier Inc. All rights reserved.
NSTL
Elsevier