[The flow cytometry in diagnostic of sepsis in children of first year of life with congenital heart disease and operated in conditions of artificial circulation]

Abstract

The study was organized to evaluate sensitivity and specificity of CD64 index and relative amount of HLA-DR+ monocytes in diagnostic of sepsis in children of first year of life after surgery correction if congenital heart disease in conditions of artificial circulation. To detect CD64 index the kit Leuko64 (Beckman Coulter USA) was applied. The relative amount of HLA-DR+ monocytes was measured by flow cytofluorimeter Navios (Beckman Coulter, USA) using combination of monoclonal antibodies CD14-APC, HLA-DR-PacificBlue, CD45-KrOr. The results of study established that CD64 index in the group with confirmed or supposed sepsis consisted 2.29 (1.96:3.32) that statistically is reliably higher (p = 0.001) than in group without sepsis. The study established no statistically reliable differences in concentration of C-reactive protein in blood serum (p-0.123), absolute amount of leukocytes in peripheral blood (p = 0.128), relative amount of HLA-DR+ monocytes (p = 0.789). It is demonstrated that value of CD64 index higher than 2.00 increases the risk of development of sepsis up to 9.4 times and can be used as a diagnostic criterion of sepsis (AUC = 0.895) with sensitivity up to 80% and specificity up to 90%. The negative prognostic significance of CD64 index and content of procalcitonin in relation to development of sepsis in children of first year of life operated in conditions of artificial circulation amounted to 74% and 76% and 77% and 64% in case of positive prognostic significance correspondingly.