Current concepts of the inflammatory response after major trauma: an update

Giannoudis, Peter V.; Dinopoulos, H.

doi:10.1016/j.injury.2003.12.008

Cited by 56 publications

(71 citation statements)

References 6 publications

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“…Hemorrhagic shock and subsequent resuscitation have been associated with the development of the systemic inflammatory response syndrome, a dysfunctional inflammatory response after injury [15,16]. Our data showing elevation of lung NFkB protein, ALT, and mild tissue injury on histology at the time of sacrifice are consistent with an ischemia reperfusion injury and activation of the systemic inflammatory response.…”

Section: Discussionsupporting

confidence: 67%

Effect of Protein C Gene Mutation on Coagulation and Inflammation in Hemorrhagic Shock

Burruss

Andakyan

Romanov

et al. 2012

Journal of Surgical Research

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Section: Discussionsupporting

confidence: 67%

Effect of Protein C Gene Mutation on Coagulation and Inflammation in Hemorrhagic Shock

Burruss

Andakyan

Romanov

et al. 2012

Journal of Surgical Research

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“…Ideally, advancing the ability to analyse immunoinflammatory molecular markers will improve our understanding of the appropriate timing for surgical intervention in high-risk patients. Studies of TNF-a, IL-1b and IL-10 as possible clinical markers of the inflammatory response have given mixed results [81]. In contrast, a direct relationship has been confirmed between systemic levels of IL-6 and IL-8 and degree of injury [82], and today IL-6 is considered the most specific marker for the magnitude of systemic inflammation.…”

Section: Discussionmentioning

confidence: 99%

Immune depression in musculoskeletal trauma

Reikerås

2010

Inflamm. Res.

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The immune responses after musculoskeletal trauma are physiological reactions of the organism to restore homeostasis. An imbalance between the early systemic inflammatory response syndrome and the later compensatory anti-inflammatory response syndrome may be responsible for organ dysfunction and increased susceptibility to infections. Cytokines are known to be integral components of the immune response, and the balance or imbalance of the different cytokines partly controls the clinical course in the patients. The major pro-inflammatory cytokines include tumor necrosis factor-alpha (TNF-a), interleukin-1beta (IL-1b), IL-6, and IL-8. These cytokines are predominantly produced by monocytes and macrophages, they mediate overlapping effects, and their actions can be additive. TNF-a and IL-1b are early regulators of the immune response, and both induce the release of secondary pro-inflammatory cytokines. IL-10 is an anti-inflammatory cytokine which reduces the synthesis of pro-inflammatory mediators. The extent of traumatic damage correlates with the immunological changes and determines a graded depression of leucocytes to express cytokines on edotoxin exposure. Correspondingly, it has become clinically evident that in unstable traumatised patients, the recommendation today is damage control orthopaedics, i.e. initial stabilisation of long bone fractures by external fixation followed by definitive stabilisation at about 1 week.

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“…35,36 Massive tissue trauma leads to an excessive inflammatory response. Cytokines and other inflammatory mediators increase the sensitivity of nociceptors in injured tissues.…”

Section: Neuroendocrine Effectsmentioning

confidence: 99%