Postinjury Inflammation and Organ Dysfunction

Crit Care Clin. 2017 Jan;33(1):167-191. doi: 10.1016/j.ccc.2016.08.006.

Abstract

The development of organ dysfunction (OD) is related to the intensity and balance between trauma-induced simultaneous, opposite inflammatory responses. Early proinflammation via innate immune system activation may cause early OD, whereas antiinflammation, via inhibition of the adaptive immune system and apoptosis, may induce immunoparalysis, impaired healing, infections, and late OD. Patients discharged with low-level OD may develop the persistent inflammation-immunosuppression catabolism syndrome. Although the incidence of multiple organ failure has decreased over time, it remains morbid, lethal, and resource intensive. However, single OD, especially acute lung injury, remains frequent. Treatment is limited, and prevention remains the mainstay strategy.

Keywords: CARS; Organ dysfunction; PICS; Postinjury inflammation; SARS; SIRS.

Publication types

  • Review

MeSH terms

  • Humans
  • Inflammation / etiology*
  • Inflammation / therapy*
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / therapy*
  • Risk Factors
  • Wounds and Injuries / complications*
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / therapy*