Postinjury immune monitoring: can multiple organ failure be predicted?
OBJECTIVE
Multiple organ failure is the main cause of late morbidity and mortality after severe injury. This disease state is driven by a dysfunctional immune system. Prediction of multiple organ failure on the basis of clinical parameters appears to be insufficient. A better understanding of immunological pathogenesis underlying multiple organ failure may lead to better prediction and innovation in treatment strategy in order to increase the survival of trauma patients.


RESULTS
Immune monitoring has increased the knowledge of the pathogenesis of multiple organ failure, but many mechanisms underlying its cause and development remain to be elucidated. Consequently, adequate predictive markers for diagnosis and monitoring still need to be developed.


CONCLUSIONS
General markers of inflammation including cytokines are correlated with posttraumatic complications with a low sensitivity and specificity and are, therefore, of little use as prognostic markers. Current findings regarding the functionality of immune cells are promising and might be of prognostic value in the near future.
Visser
Tjaakje
T
Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Pillay
Janesh
J
Koenderman
Leo
L
Leenen
Luke P H
LP
D015415:Biomarkers; D016638:Critical Illness; D016207:Cytokines / Q000097:blood*; D006801:Humans; D007107:Immune System / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000175:diagnosis*; D009102:Multiple Organ Failure / Q000097:blood / Q000175:diagnosis* / Q000276:immunology* / Q000401:mortality; D009504:Neutrophils; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications*
D015415:Biomarkers; D016207:Cytokines