Immunoinflammatory Response in Critically Ill Patients: Severe Sepsis and/or Trauma

Šurbatović, Maja; Veljović, Milić; Jevdjić, Jasna; Popović, Nikola; Djordjević, Dragan; Radaković, Sonja

doi:10.1155/2013/362793

Cited by 55 publications

(51 citation statements)

References 78 publications

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“…7 The poorly regulated inflammatory ''storm'' of sepsis has been reviewed extensively elsewhere. 8,9 Despite decades of basic science and clinical research, it remains unclear how absolute or relative concentrations, or timing of interactions of inflammatory mediators effects the evolution of inflammation and ultimately how manipulation of these mediators may become therapeutic options. Furthermore, complex interactions between inflammation, endogenous anti-inflammatory processes, coagulation and platelets, and the and most workers feel our understanding of manipulating inflammation has moved beyond the ''magic bullet'' single intervention.…”

Section: Discussionmentioning

confidence: 99%

Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations

Morris

Gray

Giovannelli

2015

Journal of the Intensive Care Society

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A novel synthetic haemabsorption column (Cytosorb TM ) has recently become commercially available. We describe its use in patients with overwhelming sepsis and consider the experience and evidence supporting its use. While Cytosorb haemabsorption is mechanistically distinct from other extracorporeal therapies in sepsis and appears effective in reducing inflammatory cytokines during sepsis, much of the basic science and clinical benefits remain unclear. Significant interactions including removal of antibiotics may be harmful and require further study. Suggestions for future research and how Cytosorb TM could be incorporated into practice are provided.

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Section: Discussionmentioning

confidence: 99%

Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations

Morris

Gray

Giovannelli

2015

Journal of the Intensive Care Society

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“…The presence of pathogens in blood or in tissues leads to the activation of systemic inflammatory process, which results in a nonspecific response from the organism (Surbatovic et al 2013). Through this synergic or antagonist action of pro-inflammatory mediators, a series of molecular modifications are produced, which later on affects the structure and function of the cell.…”

Section: Pathophysiology Of Sepsismentioning

confidence: 99%

The Expression of Nuclear Transcription Factor Kappa B (NF-κB) in the Case of Critically Ill Polytrauma Patients with Sepsis and Its Interactions with microRNAs

Păpurică¹,

Rogobete²,

Săndesc³

et al. 2016

Biochem Genet

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Critical polytrauma patients present a series of pathophysiological disturbances, biochemical and molecular dysfunction, which comprise to be the major cause of intensive care unit admission. In regard to molecular damage, there exists a series of factors, which all together contribute to the aggravation of the clinical status leading to increased mortality rate in these patients. One of the most important biochemical factors involved is the nuclear transcription factor B (NF-κB). Impaired NF-κB functioning is reflected on the clinical status of the patient through increased production of pro-inflammatory molecule, leading to multiple organ dysfunction syndrome. In addition to this, through microRNAs interactions, various pathophysiological as well as biochemical disturbances are produced, which altogether further reduce the patient's survival rate. In this paper, we would like to present the modifications seen in the expression of NF-κB in critically polytraumatized patients with sepsis. In additions to this, we would like to discuss the correlation between the microRNAs and its further implications in clinical status of these patients.

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“…Severe trauma, irrespective of mechanism, commonly causes substantial amounts of blood loss leading to decreased endothelial derived Nitric Oxide (NO), which further leads to augmented platelet aggregation, increased neutrophil infiltration and deregulation of vasorelaxation (Surbatovic et al, 2013). As expected with trauma, loss of endothelial integrity increases vascular permeability, characteristic of the innate immune response reacting to DAMPs.…”

Section: Deterioration Of the Immune System After Traumamentioning

confidence: 99%

Immunology of Septic Shock and Traumatic Injury: A Review

Heuser¹,

Frieri²,

Kumar³

et al. 2015

American Journal of Immunology

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Sepsis remains a major worldwide cause of morbidity and mortality and remains amongst the leading causes of death in medical Intensive Care Units (ICUs). Increasing injury severity associated with trauma is a significant independent risk factor for sepsis and many of these patients require intensive care unit resource utilization with increased rates of mortality. There are many postulated theories regarding the mechanism surrounding the correlation between trauma and shock. One such theory evaluated the deterioration of the immune system after trauma with the activation of Damage Associated Molecular Proteins (DAMPs) and the potential role of mitochondrial release into the bloodstream following physical injury leading to the onset of the Systemic Inflammatory Response Syndrome (SIRS). Despite these proposed theories, a breach of cellular integrity seems to unravel a multitude of immunologic responses that in essence account for the deleterious symptoms associated with sepsis. The association between traumatic injury and sepsis is very complex. This review explores the multifaceted immunoinflammatory response and gives an in depth immunologic explanation of the fundamental mediators in the initiation and continuation of the inflammatory response following the loss of cellular integrity.

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Immunoinflammatory Response in Critically Ill Patients: Severe Sepsis and/or Trauma

Cited by 55 publications

References 78 publications

Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations

Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations

The Expression of Nuclear Transcription Factor Kappa B (NF-κB) in the Case of Critically Ill Polytrauma Patients with Sepsis and Its Interactions with microRNAs

Immunology of Septic Shock and Traumatic Injury: A Review

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