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The Inflammatory Response

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Pediatric Critical Care Study Guide

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Abstract

The activation and migration of leukocytes during infection or injury and the subsequent systemic physiologic changes that occur characterize the inflammatory response. This response represents the body’s attempt to identify, contain, and eliminate pathogens, but gone awry it is an important source of morbidity and mortality in the pediatric intensive care unit (PICU). The sepsis syndrome, for example, can be thought of not as an overwhelming infection but as the body’s deadly over-reaction to microbial invasion. A great deal has been learned about the mediators and mechanisms of the inflammatory response but surprisingly few therapies have been shown to be effective in controlling it to the patients’ benefit. In fact, mounting evidence suggests that natural or iatrogenic anti-inflammatory counter-regulation can be harmful if not carefully balanced. In this chapter this balance will be explored on both intra- and extra-cellular levels. The discussion will then shift back to the bedside to review the history of immunomodulation in the ICU, describe the impact of intensive care on the inflammatory response, and highlight promising areas of research into the modulation of the inflammatory response. The literature on these subjects, both basic and clinical, is expansive and cannot be covered in an all-inclusive manner. The objective of this chapter, therefore, is to provide an overview of the inflammatory response and familiarization with enough terminology to allow informed reading of the literature and understanding of the relevance of inflammation to clinical practice.

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Authors and Affiliations

  1. Pediatric Critical Care Medicine, Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children’s Hospital, Columbus, OH, USA

    Mark W. Hall M.D.

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  1. Mark W. Hall M.D.
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Editors and Affiliations

  1. Children's Heart Group, Div. Pediatric Critical Care, Penn State Children's Hospital, University Drive 500, Hershey, 17078, Pennsylvania, USA

    Steven E. Lucking

  2. Janet Weis Children's Hospital @ Geising, Pediatric Critical Care Medicine, Temple University School of Medicine, N. Academy Ave 100, Danville, 17822, Pennsylvania, USA

    Frank A. Maffei

  3. Milton S. Hershey Medical Center, Penn State College of Medicine, University Drive 500, Hershey, 17033-2390, Pennsylvania, USA

    Robert F. Tamburro

  4. College of Medicine, Penn State Children's Hospital, Pennsylvania State University, University Drive 500, Hershey, 17078, Pennsylvania, USA

    Neal J. Thomas

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Hall, M.W. (2012). The Inflammatory Response. In: Lucking, S., Maffei, F., Tamburro, R., Thomas, N. (eds) Pediatric Critical Care Study Guide. Springer, London. https://doi.org/10.1007/978-0-85729-923-9_10

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  • DOI: https://doi.org/10.1007/978-0-85729-923-9_10

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