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ARTICLE | August 1938

LEUKOCYTE EXHAUSTION FOLLOWING SURGICAL PROCEDURES

JOHN VAN DUYN, M.D.

Arch Surg. 1938;37(2):302-310. doi:10.1001/archsurg.1938.01200020130009.

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It is often baffling to the surgeon when after an operation a patient takes an unexplained turn for the worse or follows a progressively downhill course without apparent reason. I have recently observed that in association with such a course examination of the blood frequently shows leukopenia, with a normal differential count and a marked shift to the left of the neutrophils. This picture signifies a wearing out of the leukopoietic power and offers an explanation of the patient's lack of response to ordinary measures. This leukocyte exhaustion always indicates a serious prognosis and is probably more common than is generally realized. It therefore, I believe, deserves more recognition as a complication following surgical procedures.

Leukocyte exhaustion was first described by Turk¹ in 1907 and is usually considered as due to the "overwhelming irritation" of severe sepsis (Schilling²) or to "long continued infection as the result of a

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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VAN DUYN J, 2d. LEUKOCYTE EXHAUSTION FOLLOWING SURGICAL PROCEDURES. Arch Surg. 1938;37(2):302-310. doi:10.1001/archsurg.1938.01200020130009.

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