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Systemic Response To Injury

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This document summarizes the systemic response to injury and infection in the body. It discusses how injuries trigger neuroendocrine and inflammatory responses to restore homeostasis. The response has two phases - an initial pro-inflammatory response to fight infection, followed by an anti-inflammatory phase to prevent excessive inflammation and restore homeostasis. It provides details on the hormones, cytokines and other mediators involved in this response, including their effects on various organ systems.

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SYSTEMIC RESPONSE TO INJURY James Taclin C. Banez, MD, FPSGS, FPCS
[object Object],[object Object]
[object Object],[object Object]
Systemic Inflammatory Response Syndrome (SIRS) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Terminologies Term Definition Infection Identifiable source of microbial insult SIRS Two or more following criteria: - Temp >/= 38C or </= 36C - Heart rate >/= 90 beats/min - Respiratory rate >/= 20 breaths/min or PaCO2 </= 32mmHg or mechanical ventilation - WBC >/= 12,000/ul or </= 4000/ul or >/= 10% band forms Sepsis Identifiable source of infection + SIRS Severe sepsis Sepsis + organ dysfunction Septic shock Sepsis + cardiovascular collapse (requiring vasopressor support)
Central Nervous System Regulation of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Central Nervous System Regulation of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Systemic Neuro-Endocrine Reflexes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Systemic Neuro-Endocrine Reflexes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Systemic Neuro-Endocrine Reflexes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Systemic Neuro-Endocrine Reflexes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Systemic Neuro-Endocrine Reflexes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hormone Response to Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mediators of Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cytokines ,[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CYTOKINES ,[object Object],[object Object],[object Object]
Cell-Mediated Inflammatory Response ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cell-Mediated Inflammatory Response ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cell-Mediated Inflammatory Response ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cell-Mediated Inflammatory Response ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cell-Mediated Inflammatory Response ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cell-Mediated Inflammatory Response ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endothelium-Mediated Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endothelium-Mediated Injury ,[object Object]
Endothelium-Mediated Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endothelium-Mediated Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endothelium-Mediated Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
END OF FIRST PART
Metabolic Changes and Nutritional Management of Surgical Patients James Taclin C. Banez, MD, FPSGS, FPCS
Majority of surgical patients: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical Patients that Needs Nutritional Support ,[object Object],[object Object],[object Object]
Metabolic Changes in Surgical Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Metabolic Response to Starvation ,[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object]
Metabolism of Injured Patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Systemic Response To Injury

  • 1. SYSTEMIC RESPONSE TO INJURY James Taclin C. Banez, MD, FPSGS, FPCS
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  • 5. Terminologies Term Definition Infection Identifiable source of microbial insult SIRS Two or more following criteria: - Temp >/= 38C or </= 36C - Heart rate >/= 90 beats/min - Respiratory rate >/= 20 breaths/min or PaCO2 </= 32mmHg or mechanical ventilation - WBC >/= 12,000/ul or </= 4000/ul or >/= 10% band forms Sepsis Identifiable source of infection + SIRS Severe sepsis Sepsis + organ dysfunction Septic shock Sepsis + cardiovascular collapse (requiring vasopressor support)
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  • 59. END OF FIRST PART
  • 60. Metabolic Changes and Nutritional Management of Surgical Patients James Taclin C. Banez, MD, FPSGS, FPCS
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Editor's Notes

  1. Ree and duration of (-)