Inflammatory and immune effects

Severe tissue injury results in the systemic release of inflammatory mediators, which may cause an inflammatory reaction in remote organs, such as the lung, resulting in acute respiratory distress, systemic inflammatory response, and multiple organ failure.

Early after injury, elevated blood levels of C3a, C5a, C3d, C5b-C9, elastase, tumor necrosis factor-a, and interleukin 6 (IL-6) have been shown to correlate with the severity of injury as well as with the onset of acute respiratory distress syndrome. In addition, plasma cytokine levels (IL-6 and C-reactive protein) are significantly higher with 'classical' than with laparoscopic cholecystectomy, indicating that the extent of operative trauma also correlates with the systemic inflammatory response.

In general, the release of inflammatory mediators in trauma causes an immediate, marked, and transient vasodilatation. The microcirculation of the traumatized tissue is isolated from neurohumeral or metabolic control.

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