Nosocomial infections and immunity: lesson from brain-injured patients

被引：72

作者：

Dziedzic, T ^{[1
]}

Slowik, A ^{[1
]}

Szczudlik, A ^{[1
]}

机构：

[1] Jagiellonian Univ, Dept Neurol, PL-31007 Krakow, Poland

来源：

CRITICAL CARE | 2004年 / 8卷 / 04期

关键词：

brain injury; immunodepression; infection; intensive care;

D O I：

10.1186/cc2828

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Of brain-injured patients admitted to intensive care units, a significant number acquires nosocomial infections. Increased susceptibility to infectious agents could, at least partly, be due to transient immunodepression triggered by brain damage. Immune deficiency in patients with severe brain injury primarily involves T cell dysfunction. However, humoral and phagocytic deficiencies are also detectable. Activation of the hypothalamo-pituitary-adrenal axis and the sympathetic nervous system plays a crucial role in brain-mediated immunodepression. In this review we discuss the role of immunodepression in the development of nosocomial infections and clinical trials on immunomodulation in brain-injured patients with hospital-acquired infections.

引用

页码：266 / 270

页数：5

共 39 条

[1]

ALEJANDRIA MM, 2003, COCHRANE LIB

[2] Clinical review: Immunodepression in the surgical patient and increased susceptibility to infection [J].

Angele M.K. ;

Faist E. .

Critical Care, 6 (4) :298-305

[3] Early onset pneumonia in neurosurgical intensive care unit patients [J].

Berrouane, Y ;

Daudenthun, I ;

Riegel, B ;

Emery, MN ;

Martin, G ;

Krivosic, R ;

Grandbastien, B .

JOURNAL OF HOSPITAL INFECTION, 1998, 40 (04) :275-280

[4] MECHANISM OF INCREASED SUSCEPTIBILITY TO INFECTION FOLLOWING HEMORRHAGE [J].

CHAUDRY, IH ;

AYALA, A .

AMERICAN JOURNAL OF SURGERY, 1993, 165 (2A) :S59-S67

[5] Intracerebral hemorrhage triggers interleukin-6 and interleukin-10 release in blood [J].

Dziedzic, T ;

Bartus, S ;

Klimkowicz, A ;

Motyl, M ;

Slowik, A ;

Szczudlik, A .

STROKE, 2002, 33 (09) :2334-2335

[6]

Fabregas N, 2002, Minerva Anestesiol, V68, P285

[7] Proinflammatory cytokines: Indicators of infection in high-risk patients [J].

Fassbender, K ;

Dempfle, CE ;

Mielke, O ;

Rossol, S ;

Schneider, S ;

Dollman, M ;

Hennerici, M .

JOURNAL OF LABORATORY AND CLINICAL MEDICINE, 1997, 130 (05) :535-539

[8] The effect of midazolam and propofol on interleukin-8 from human polymorphonuclear leukocytes [J].

Galley, HF ;

Dubbels, AM ;

Webster, NR .

ANESTHESIA AND ANALGESIA, 1998, 86 (06) :1289-1293

[9] CDC DEFINITIONS FOR NOSOCOMIAL INFECTIONS, 1988 [J].

GARNER, JS ;

JARVIS, WR ;

EMORI, TG ;

HORAN, TC ;

HUGHES, JM .

AMERICAN JOURNAL OF INFECTION CONTROL, 1988, 16 (03) :128-140

[10] SAFETY AND EFFICACY OF INTRAVENOUS IMMUNOGLOBULIN PROPHYLAXIS IN PEDIATRIC HEAD TRAUMA PATIENTS - A DOUBLE-BLIND CONTROLLED TRIAL [J].

GOODING, AM ;

BASTIAN, JF ;

PETERSON, BM ;

WILSON, NW .

JOURNAL OF CRITICAL CARE, 1993, 8 (04) :212-216

← 1 2 3 4 →