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The systemic immune response to trauma : an overview of pathophysiology and treatment
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Lord, J. M. , Midwinter, M., Chen, Y-F., Bellini, A., Brohi, K., Kovacs, E. , Koenderman, L., Kubes, P. and Lilford, Richard (2014) The systemic immune response to trauma : an overview of pathophysiology and treatment. The Lancet, 384 (9952). pp. 1455-1465. doi:10.1016/S0140-6736(14)60687-5 ISSN 0140-6736.
An open access version can be found in:
Official URL: http://dx.doi.org/10.1016/S0140-6736(14)60687-5
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.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > RC Internal medicine | ||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Critical care medicine -- Evaluation, Emergency medicine, Wounds and injuries -- Treatment, Traumatology | ||||
| Journal or Publication Title: | The Lancet | ||||
| Publisher: | Lancet Publishing Group | ||||
| ISSN: | 0140-6736 | ||||
| Official Date: | October 2014 | ||||
| Dates: |
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| Volume: | 384 | ||||
| Number: | 9952 | ||||
| Page Range: | pp. 1455-1465 | ||||
| DOI: | 10.1016/S0140-6736(14)60687-5 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||
| Open Access Version: |
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