Matt Harmon

56 Chapter three Figure 2 . Plasma cytokine levels in sepsis patients stratified according to the presence of hypothermia. 10 −1 10 0 10 1 10 2 10 3 10 4 0 2 4 IL−10 (pg/ml) 10 0 10 1 10 2 10 3 10 4 0 2 4 IL−8 (pg/ml) 10 −1 10 0 10 1 10 2 10 3 10 4 10 5 10 6 0 2 4 IL−6 (pg/ml) days after admission Interleukin-6 Interleukin-8 days after admission days after admission Interleukin-10 Healthy subjects No hypothermia Hypothermia Box-and-whisker diagrams depict the median and lower quartile, upper quartile and respective 1.5 IQR as whiskers. Dashed lines represent median levels in healthy volunteers. Differences between patient groups were not significant. Hypothermia does not affect leukocyte responsiveness upon ex vivo stimulation As hypothermia has been postulated to be an early clinical predictor of sepsis-induced immunosuppression 10 , we investigated the association between hypothermia and the responsiveness of circulating immune effector cells to LPS, as a marker of sepsis-induced immunosuppression 22 . Whole blood from 15 sepsis patients, of whom 5 hypothermic, was stimulated ex vivo and compared with 18 healthy age- and gender-matched volunteers. Clinical characteristics of sepsis patients are displayed in Supplemental Table 5. Patients with sepsis had a reduced capacity to release TNF- α and IL-1 β upon LPS stimulation compared to healthy controls (Figure 3). However, no differences in cellular responsiveness were observed between hypothermic and nonhypothermic patients with sepsis.