IMMUNOLOGICAL FINDING IN PATIENTS WITH MA JOR MULTIPLE TRAUMA

Immunologial complications frequently occur during the clinical course in patients with multiple injuries. The increased release of pro-infl ammatory mediators during the immunological response to trauma may lea d to the systemic inflammatory response syndrome (SIRS) and furthermor e, to multisystem organ failure (MOF), which is associated with a mort ality of up to 80%. The development of multiple organ failure followin g major trauma is associated with remote organ failure, the dysfunctio n of organs which were not initially affected by the traum. This manus cript reviews recent data in experimental trauma research and offers a more detailed evaluation of the immunological findings in trauma pati ents. Hn particular, the role of pro- and anti-inflammatory cytokines in the development or SIRS, MOF and ROF is discussed. Despite the enor mous progress in clinical immunology and the available data on trauma- induced immune dysfunction, a large number of questions still remain t o be answered before the immunological alterations following severe tr auma can be beneficially influenced by immunomodulatory therapeutic ef forts.