Immunostimulation in Sepsis
Infectious complications remain a major problem in critically ill patients following trauma, burn injury, major surgery, or septic shock. The high risk of infection in these patients is related in part to the development of an acquired deficiency in host defense. Secondary infections can in turn result in sepsis which if severe is associated with a very high mortality. Over the last two decades our understanding of the pathophysiology of sepsis has progressed considerably. It is now clear that an overwhelming systemic inflammatory response to invasion by bacteria and fungi and/or their toxic products is important in the pathogenesis of SIRS, sepsis and multiple organ failure. Since TNF and IL-1 can mimic sepsis and septic shock in animal models, several recent clinical trials have focused on neutralization of these inflammatory mediators. These trials, however, have had very disappointing results.
KeywordsCorticosteroid Prostaglandin Half Life Psoriasis Catecholamine
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- 7.Volk HD, Reinke P, Falck P, Staffa G, Briedigkeit H, von Baehr R. Diagnostic value of an immune monitoring program for the clinical management of immunosuppressed patients with septic complications. Clin Transplant 1989; 3: 246–252.Google Scholar
- 8.Döcke WD, Reinke P, Syrbe U, Platzer C, Asadullah K, Krausch D, Zuckermann H, Volk HD. Immunoparalysis in sepsis — from phenomenon to treatment strategies. Transplantationsmedizin 1997; 9: 55–65.Google Scholar
- 14.Wolk K, Döcke WD, v.Baehr V, Volk HD, Sabat R. Impaired antigen presentation by human monocytes during endotoxin tolerance. Blood 2000; in press.Google Scholar
- 18.Reinke P. Plasmapheresis in the therapy of septic disease. Int J Artif Organs 1997; 19: 127–128.Google Scholar