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SP Systemic response to injury (SYSTEMIC RESPONSE TO INJURY (• Nervous…
SP Systemic response to injury
immflammatory response
response
restore恢復 tissue function
remove invading bacteria and microrganism
two phase (pros and cons)
prioinflammatory 促炎階段
produce inflammation
activation of cellular processes
restore tissue function and eradicate invading microorganisms,
antiinflammatory (counterregulatory phase) 抗炎（反調節階段
prevention too much inflammation
Restoring homeostasis in the individual.
Injuries of limited duration are usually followed
functional restoration
minimal intervention.最小干預
without appropriate and timely intervention, can lead to multiple-organ failure & adversely impact patient survival.
Clinical Spectrum of Infection and Systemic Inflammatory Response Syndrome
SIRS(two or more following criteria )
temperature
≥38◦C
≤36◦C
Heart rate ≥90 beats/min
breath rate
respiratory rate ≥20 br/min
PaCO2 ≤32 mm Hg
mechanical ventilation輔助或替代自主呼吸
leucocyte
≤4000/μL
≥10% band forms
≥12,000/μL
Sepsis:Identifiable source of infection + SIRS
infection :Identifiable source of microbial insult
Severe sepsis:Sepsis + organ dysfunction
Septic shock:Sepsis + cardiovascular collapse (requiring vasopressor 需要血管加壓劑
SYSTEMIC RESPONSE TO INJURY
• Nervous system regulation of inflammation
• Mediators of inflamation
• Cytokine response to injury
• Cellular response to injury
• Cell-mediated inflamatory response
• Hormonal response to injury
nervous system regulation of inflammation
CNS, via autonomic signaling
afferent nerve and the sympathetic activation
tissue injury -->impulse the afferent fibers--> dorsal horn of the spinal cord and the lateral spinothalamic tract --> thalamus --> metabolic response
metabolic response