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Treating Immunologic Instability: A Change in Focus

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine 1999

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1999))

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Abstract

Although controversy still exists surrounding the classification and epidemiology of the inflammatory response, inflammation remains a hallmark of critical illness. Linkage between inflammatory mediator levels and patient outcome has been estab lished for a wide array of conditions [1–3]. However, doubt remains about whether cytokines are directly responsible for the significant morbidity and mortality seen in these conditions or are simply markers of the underlying pathophysiology. The failure of immunologic therapies to modify outcome in sepsis underscores this doubt. Still, cytokines exist in a vast and complex network with multiple feedback and co-stimulatory limbs. No single mediator has proved decisive in humans although some have clear primacy in lower animals. While therapy targeted at blocking individual cytokines has failed, some hope still exists based on pooled estimates from these studies [4]. Perhaps combination therapy will be required to achieve any significant effect on survival.

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  1. J. A. Kellum
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  2. K. ALKharfy
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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Kellum, J.A., ALKharfy, K. (1999). Treating Immunologic Instability: A Change in Focus. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1999. Yearbook of Intensive Care and Emergency Medicine, vol 1999. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13453-5_4

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  • DOI: https://doi.org/10.1007/978-3-662-13453-5_4

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