Warning: Undefined variable $zfal in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Deprecated: str_replace(): Passing null to parameter #3 ($subject) of type array|string is deprecated in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 530
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 531
English Wikipedia
Nephropedia Template TP (
Twit Text
DeepDyve Pubget Overpricing |
lüll The nonspecific inflammatory response to injury Mayers I; Johnson DCan J Anaesth 1998[Sep]; 45 (9): 871-9PURPOSE: The role of the nonspecific inflammatory response in causing injury related to surgery has become better understood over the last decade. There are complex interactions between neutrophils, cytokines and nitric oxide metabolites that may cause organ injury following surgery. The purpose of this review is to summarize some of the processes causing injury through these nonspecific pathways. METHODS: A review of the medical and anaesthetic literature related to inflammation, neutrophils and pro-inflammatory cytokines were performed using Medline. Bibliographies of relevant articles were searched and additional articles were then selected and reviewed. RESULTS: Pro-inflammatory cytokines, such as tumour necrosis factor, are released in response to a variety of noxious stimuli (e.g. burns, sepsis, or CABG surgery). These cytokines cause activation of neutrophils with increased upregulation of adhesion complexes on neutrophils and vascular endothelium. Nitric oxide synthase activity is also increased with a resultant increased production of nitric oxide. The increased nitric oxide concentration in the presence of superoxide free radicals secreted by activated neutrophils forms peroxynitrite, a more reactive and toxic molecule. Once this process is initiated, diffuse organ injury can result. Although some information related to specific anaesthetics is available, firm recommendations related to clinical practice cannot be made. CONCLUSIONS: There is a complex interplay of inflammatory mediators that can cause injury. Although specific clinical applications for manipulating these pathways are not yet generally available, this area holds promise to develop new techniques to improve outcomes following surgery.|*Surgical Procedures, Operative[MESH]|Cell Adhesion Molecules/physiology[MESH]|Cytokines/physiology[MESH]|Endothelium, Vascular/metabolism[MESH]|Free Radical Scavengers/metabolism[MESH]|Humans[MESH]|Inflammation Mediators/physiology[MESH]|Inflammation/*etiology[MESH]|Neutrophil Activation/physiology[MESH]|Neutrophils/metabolism/physiology[MESH]|Nitrates/metabolism[MESH]|Nitric Oxide Synthase/physiology[MESH]|Nitric Oxide/metabolism[MESH]|Oxidants/metabolism[MESH]|Reactive Oxygen Species/metabolism[MESH]|Superoxides/metabolism[MESH]|Tumor Necrosis Factor-alpha/physiology[MESH]|Up-Regulation[MESH] |