AffiliationDepartment of Surgery, Cork University Hospital, Ireland. email@example.com
Injury Severity Score
Systemic Inflammatory Response Syndrome/diagnosis/*immunology/mortality
Wounds and Injuries/diagnosis/*immunology/mortality
MetadataShow full item record
CitationSurgeon. 2006 Feb;4(1):23-31.
JournalThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
AbstractImmediate and early trauma death rates are determined by "first hits" such as hypoxia, hypotension and organ injury, while late mortality correlates closely with "second hits" such as infection. An imbalance between the early systemic inflammatory response (SIRS), and the later compensatory counter-inflammatory response (CARS), is considered to be responsible for much post-traumatic morbidity and mortality. From a clinical perspective, this remains a significant healthcare problem, which has stimulated decades of experimental and clinical research aimed at understanding the functional effects of injury on the immune system. This review describes the impact of injury on the innate and adaptive immune systems. Though it is worth noting that the features of the immune response to injury overlap in many areas with immune dysregulation in sepsis, we attempt here to elucidate the mechanism by which injury predisposes to infection rather than to describe the alterations in host immunity consequent to established sepsis.