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Sepsis and infection are the major enemies of the intensive care patient in whom immunological defenses are severely impaired. This major problem is thefocus of attention in this book, based on the presentation of the First International Congress on the Immune Consequences of Trauma, Shock, and Sepsis, which is one of the first attempts to exchange ideas on the state-of-the-art in this area of immunology. Both basic and clinical research, including new centres of attention, are described. The growing role of immunology in medicine opens new avenues to the under- standing of trauma and sepsis and will allow the design of novel therapeutic approaches.
This book presents a unique overview of all aspects of host defense alterations under stressful conditions. It is based on the most important contributions given at the "2nd International Congress on the Immune Consequences of Trauma, Shock, and Sepsis-Mechanisms and Therapeutic Approaches," which was held in Munich under the auspices of the most distinguished scientific societies involved in this field (Society of Critical Care Medicine, European Society of Intensive Care Medicine, Societe Internationale de Chirurgie, Surgical Infection Society, Surgical Infection Society Europe, European Society for Surgical Research, International Society for Burn Injury, American Association for the Surgery of Trauma, and National Institutes of Health). Since the first conference of this kind in 1988, new information from basic studies and clinical trials has provided exciting and novel insights into the immune dysfunctions accom panying trauma, shock, and sepsis. The volume is divided into 18 parts presenting the structural background of trauma-induced alterations of immune and imflammatory mechanisms as well as the currently discussed therapeutic interventions designed to restore or maintain normal host defenses following major injury. Introducing the general theme of the book is a summary of the essential keystones of trauma and sepsis-related immune deficits. Discussions of the progress in trauma care brought through better understanding of the cell biology of injury and of the major clinical factors that influence host defense integrity in operative medicine provide a setting for understanding the wide array of detailed information that is presented thereafter.
This book presents a unique overview of all aspects of host defense alterations under stressful conditions. It is based on the most important contributions given at the "2nd International Congress on the Immune Consequences of Trauma, Shock, and Sepsis-Mechanisms and Therapeutic Approaches," which was held in Munich under the auspices of the most distinguished scientific societies involved in this field (Society of Critical Care Medicine, European Society of Intensive Care Medicine, Societe Internationale de Chirurgie, Surgical Infection Society, Surgical Infection Society Europe, European Society for Surgical Research, International Society for Burn Injury, American Association for the Surgery of Trauma, and National Institutes of Health). Since the first conference of this kind in 1988, new information from basic studies and clinical trials has provided exciting and novel insights into the immune dysfunctions accom panying trauma, shock, and sepsis. The volume is divided into 18 parts presenting the structural background of trauma-induced alterations of immune and imflammatory mechanisms as well as the currently discussed therapeutic interventions designed to restore or maintain normal host defenses following major injury. Introducing the general theme of the book is a summary of the essential keystones of trauma and sepsis-related immune deficits. Discussions of the progress in trauma care brought through better understanding of the cell biology of injury and of the major clinical factors that influence host defense integrity in operative medicine provide a setting for understanding the wide array of detailed information that is presented thereafter.
This book contains a unique overview of the sequence of steps of host defense impairment that result from injury and lead to multiple organ dysfunction syndrome. The crucial alterations of immune and inflammatory mechanisms as they are seen during ischemia, during inter- mediate inflammatory phases, and in states of bacterial sepsis are described in detail. The role of endotoxin, its mechanisms of action, and potential counterregulatory strategies to neutralize endotoxin in order to protect from shock are discussed, as there are major etiologic factors leading to organ failure such as hepatic cellular injury and bacterial translocation. Cytokines, as the central mediators in acute phase states and the modulation of cytokine action are then evaluated carefully. In the discussion of the clinical aspects of multiple organ failure, the antibiotic interactions with host defenses, the augmentation of immunoreactivity with special nutrients and the newest insights into the regulation of wound repair are elucidated. The final sections of this book deal with therapeutic immunomodulatory approaches for the prevention ofinfections and with interventional strategies in the therapy of septic shock.