General Definitions Flashcards
Sepsis
SIRS criteria with identified source of infection
Severe Sepsis
Sepsis (SIRS + identified infection source) + organ failure
Septic Shock
Sepsis (SIRS + identified source of infection) + Cardiovascular collapse
SIRS vs. CARS
SIRS = pro-inflammatory state (phase I of inflamm. response)
CARS = COUNTER/anti-inflamm. (Phase II).
*modulates phase I, mediated by cholinergic (nACh) signaling from vagus nerve & CNS
ACTH in injured patient
Stimulated by: CRH, pain, anxiety, vasopressin, AngII, CCK, VIP, etc.
Effect: glucocorticoid production (cortisol, steroids, aldo)
=> attenuate inflamm. response
Cortisol
(a glucocorticoid, release stimulated by ACTH)
potentiates effects of glucagon & epinephrine, reduces TGF-b
=> hyperglycemia, reduced wound healing
MIF (Macrophage migration-Inhibitory Factor)
released from Ant. pituitary during stress to down-regulate effect of cortisol
=> renews immune response
Catecholamines
(Epinephrine, Norepinephrine, Dopamine)
= vasoactive NTs & anti-inflamm. immune modulators
IL-6
a cytokine released from macrophages.
*Plasma levels are proportional to the degree of injury during surgery
IL-8
neutrophil chemoattractant, stimulated by critical illness & released by macrophages.
*associated with disease severity and end organ dysfunction during sepsis
anti-inflammatory cytokines
IL-4: –l macrophages, stimulates T cell prolif & B cell class-switching
IL-10: from monocytes, –l TNF & IL-1
IL-13: –l release of TNF, IL-1, IL-6, and IL-8, *increased in septic shock
IL-18
synth by macrophages, activates NK-kB.
*mediates hepatotoxicity associated with Fas ligand and TNF
INF-gamma
- secreted by T lymphocytes, NK cells, and APCs in response to bacterial antigens, IL-2, etc.
- stimulates the release of IL-12 and IL-18
