Godinho Mauricio, Padim Pedro, Evora Paulo Roberto B, Scarpelini Sandro
Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil.
Rev Col Bras Cir. 2015 Jul-Aug;42(4):273-8. doi: 10.1590/0100-69912015004013.
Trauma is one of the world's leading causes of death within the first 40 years of life and thus a significant health problem. Trauma accounts for nearly a third of the lost years of productive life before 65 years of age and is associated with infection, hemorrhagic shock, reperfusion syndrome, and inflammation. The control of hemorrhage, coagulopathy, optimal use of blood products, balancing hypo and hyperperfusion, and hemostatic resuscitation improve survival in cases of trauma with massive hemorrhage. This review discusses inflammation in the context of trauma-associated hemorrhagic shock. When one considers the known immunomodulatory effects of traumatic injury, allogeneic blood transfusion, and the overlap between patient populations, it is surprising that so few studies have assessed their combined effects on immune function. We also discuss the relative benefits of curbing inflammation rather than attempting to prevent it.
创伤是40岁前全球主要的死亡原因之一，因此是一个重大的健康问题。创伤导致65岁前近三分之一的 productive life 损失年数，并与感染、失血性休克、再灌注综合征和炎症相关。控制出血、凝血障碍、优化血液制品的使用、平衡低灌注和高灌注以及止血复苏可提高大出血创伤病例的生存率。本综述讨论了创伤相关失血性休克背景下的炎症。当考虑到创伤性损伤、异体输血的已知免疫调节作用以及患者群体之间的重叠时，令人惊讶的是，很少有研究评估它们对免疫功能的综合影响。我们还讨论了抑制炎症而非试图预防炎症的相对益处。
