RESUMEN
Thermal injury induce a two-phase inflammatory response: first, a pro-inflammatory status, resulting in a systemic inflammatory response syndrome, then an anti-inflammatory phase characterized by a profound defect in cellular-mediated immunity. This inflammatory reaction proceeds from complex phenomenons in whom many cellular elements are involved (macrophage is the central one) and very complex molecular products interact (especially cytokines). These phenomenons promote significant physiopathologic consequences, especially on cardiovascular homeostasis and endothelial permeability, that lower the prognosis. The inflammatory reaction can be modified, enhanced or maintained by adverse events (i.e. infection) resulting in degradation of clinical situation. Despite a better comprehension of the phenomenons underlying this inflammatory process, diagnosis or therapeutic applications are at that time disappointing.
Asunto(s)
Quemaduras/fisiopatología , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Biomarcadores , Quemaduras/complicaciones , Quemaduras/inmunología , Quemaduras/cirugía , Permeabilidad Capilar , Citocinas/fisiología , Desbridamiento , Radicales Libres , Hemodinámica , Hemofiltración , Humanos , Inmunidad Celular , Infecciones/complicaciones , Mediadores de Inflamación , Hierro/metabolismo , Macrófagos/fisiología , Modelos Biológicos , Pronóstico , Trasplante de Piel , Linfocitos T/inmunología , Trombofilia/etiologíaRESUMEN
Three infants aged less than 2 months were hospitalized for malignant pertussis. Echocardiography showed pulmonary hypertension. High-frequency oscillations and nitric oxide were ineffective. Respiratory and hemodynamic conditions deteriorated secondarily. The third case received an exchange transfusion without success. All three infants died following multiorgan failure. Malignant pertussis is the leading cause of infectious death in infants less than 2 months of age, treatment is often ineffective, and prevention, targeting the population of young adults, is particularly important.