Immunology and Infectious Disease

Author: Lesley A. Doughty
Published: January 2003
Publisher: Kluwer Academic Publishers
ISBN: 1402073070
Hardcover Book
Number of Pages: 288

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This unique volume provides a mechanistic look at key aspects of the inflammatory response seen in critical illness. Key cells and mediators involved in the innate inflammatory response and the pathways employed to combat infection or respond to injury are emphasized. It has become clear that a delicate balance exists to allow eradication of infection with minimal immune-mediated tissue injury in the process. For this reason, an up-to-date discussion of how the inflammatory response down regulates itself has been included. The inflammatory response in the critically ill is vastly different than in healthy hosts. Discussions about the mechanisms of pharmacologic immune suppression and other less commonly considered immunomodulated states seen frequently in critical care medicine have been included. Given the differences in immune function seen in critical illness, the importance of considering the immune system an organ whose function must be monitored and optimized for the best possible outcome has been highlighted. In addition, we have included up-to-date discussions of prevention and diagnostic approaches to extremely common infectious entities which must be monitored for and treated appropriately in the setting of critical illness induced immune dysfunction.

The reaction of the immune system is different in organisms responding to disease and in healthy patients. Stressing the understanding of how the inflammatory response is mediated in disease, Doughty (pediatric critical care medicine, Rhode Island Hospital) and Linden (critical care medicine and infectious disease, U. of Pittsburgh Medical Center) present ten papers that explore such issues as activation of immune response, pharmacological mechanisms of immune suppression, monitoring strategies, catheter related infections, and detection of infection.

Table of Contents:

List of Contributors
1 Host Microbicidal Actions of the Innate Immune Response 1
2 Activation of the Innate Immune Response in Critical Illness 19
3 Down-Regulation of the Immune Response 41
4 Mechanisms of Pharmacologic Immune Suppression 79
5 Modulation of the Immune Response in Critical Illness/Injury 115
6 Immune Monitoring and Strategies for Immune Modulation
7 Central Venous Catheter Related Infections: The Role of Antimicrobial Catheters 187
8 Discrimination of True Lower Respiratory Tract Infection in the Mechanically Ventilated Patient 217
9 Detection of Urinary Tract Infection in the Catheterized ICU Patient 241
10 Antimicrobial Choices and Dosing Strategies to Maximize Efficacy and Minimize the Development of Bacterial Resistance 257

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