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Journal of Intensive Care Medicine, Vol. 21, No. 3, 160-172 (2006)
DOI: 10.1177/0885066605284330
© 2006 SAGE Publications

Reviews

Immunologic Responses to Critical Injury and Sepsis

Jason W. Smith, MD

Department of Surgery and Burn & Shock Trauma Institute, Loyola University Medical Center, Maywood, IL

Richard L. Gamelli, MD

Department of Surgery and Burn & Shock Trauma Institute, Loyola University Medical Center, Maywood, IL

Stephen B. Jones, PhD

Department of Physiology, Loyola University Medical Center, Maywood, IL

Ravi Shankar, PhD

Department of Surgery and Burn & Shock Trauma Institute, Loyola University Medical Center, Maywood, IL, rshanka{at}lumc.edu

Almost 2 million patients are admitted to hospitals in the United States each year for treatment of traumatic injuries, and these patients are at increased risk of late infections and complications of systemic inflammation as a result of injury. Host response to injury involves a general activation of multiple systems in defending the organism from hemorrhagic or infectious death. Clinicians have the capability to support the critically injured through their traumatic insult with surgery and improved critical care, but the inflammatory response generated by such injuries creates new challenges in the management of these patients. It has long been known that local tissue injury induces systemic changes in the traumatized patient that are often maladaptive. This article reviews the effects of injury on the function of immune system cells and highlights some of the clinical sequelae of this deranged inflammatory-immune interaction.

Key Words: trauma • inflammation • host response • innate immunity • adaptive immunity


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