The systemic immune response to trauma: an overview of pathophysiology and treatment

Lord, Janet M., Midwinter, Mark J., Chen, Yen-Fu, Belli, Antonio, Brohi, Karim, Kovacs, Elizabeth J., Koenderman, Leo, Kubes, Paul and Lilford, Richard J. (2014) The systemic immune response to trauma: an overview of pathophysiology and treatment. Lancet, 384 9952: 1455-1465. doi:10.1016/S0140-6736(14)60687-5

Author Lord, Janet M.
Midwinter, Mark J.
Chen, Yen-Fu
Belli, Antonio
Brohi, Karim
Kovacs, Elizabeth J.
Koenderman, Leo
Kubes, Paul
Lilford, Richard J.
Title The systemic immune response to trauma: an overview of pathophysiology and treatment
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
Publication date 2014-10-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/S0140-6736(14)60687-5
Open Access Status Not yet assessed
Volume 384
Issue 9952
Start page 1455
End page 1465
Total pages 11
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Language eng
Formatted abstract
Improvements in the control of haemorrhage after trauma have resulted in the survival of many people who would otherwise have died from the initial loss of blood. However, the danger is not over once bleeding has been arrested and blood pressure restored. Two-thirds of patients who die following major trauma now do so as a result of causes other than exsanguination. Trauma evokes a systemic reaction that includes an acute, non-specific, immune response associated, paradoxically, with reduced resistance to infection. The result is damage to multiple organs caused by the initial cascade of inflammation aggravated by subsequent sepsis to which the body has become susceptible. This Series examines the biological mechanisms and clinical implications of the cascade of events caused by large-scale trauma that leads to multiorgan failure and death, despite the stemming of blood loss. Furthermore, the stark and robust epidemiological finding—namely, that age has a profound influence on the chances of surviving trauma irrespective of the nature and severity of the injury—will be explored. Advances in our understanding of the inflammatory response to trauma, the impact of ageing on this response, and how this information has led to new and emerging treatments aimed at combating immune dysregulation and reduced immunity after injury will also be discussed.
Keyword Randomized Controlled-Trials
Critically-Ill Patients
II Clinical-Trial
Multiple Trauma
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID NIH AG018859
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 76 times in Thomson Reuters Web of Science Article | Citations
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