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The Inflammatory and Barrier Response After Polytrauma

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Textbook of Polytrauma Management

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Abstract

Polytrauma results in a rapid immune response. The exposed molecular danger of both damaged host cells and microbes leads to the activation of fluid and cellular phase immune systems, including the coagulation system, complement cascade and leukocytes. The resultant compartmentalised and systemic inflammatory response can lead to barrier dysfunction, which in turn exacerbates to reduction in cellular oxygen support and metabolic waste clearance. As main risk factors, haemorrhagic shock with hypoxic conditions are major drivers of the inflammatory immune response and the associated barrier breakdown. These changes contribute to the development of cellular disruption and multiple organ dysfunction syndrome, and when prolonged, to additional structural damage and a poor outcome. The application of real-time clinical immune monitoring should be considered as a mandatory component for future immunomodulatory therapeutic strategies as a promising integral part of surgical and anaesthesiological management to improve the quality of life and outcome after polytrauma.

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Authors and Affiliations

  1. Institute of Clinical and Experimental Trauma-Immunology, University Hospital of Ulm, Ulm, Germany

    Ebru Karasu & Markus Huber-Lang

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  1. Ebru Karasu
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  2. Markus Huber-Lang
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Correspondence to Markus Huber-Lang .

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Editors and Affiliations

  1. Department of Trauma Surgery, University Hospital Zürich, Zürich, Switzerland

    Hans-Christoph Pape

  2. Department of Orthopaedic Surgery & Sports Medicine, The University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Joseph Borrelli Jr.

  3. Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA

    Ernest E. Moore

  4. Klinik für Traumatologie, University Hospital of Zürich, Zürich, Switzerland

    Roman Pfeifer

  5. Rocky Vista University, College of Osteopathic Medicine, Parker, CO, USA

    Philip F. Stahel

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Karasu, E., Huber-Lang, M. (2022). The Inflammatory and Barrier Response After Polytrauma. In: Pape, HC., Borrelli Jr., J., Moore, E.E., Pfeifer, R., Stahel, P.F. (eds) Textbook of Polytrauma Management . Springer, Cham. https://doi.org/10.1007/978-3-030-95906-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-95906-7_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95905-0

  • Online ISBN: 978-3-030-95906-7

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