Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- SECTION 1 Admission to Critical Care
- SECTION 2 General Considerations in Cardiothoracic Critical Care
- SECTION 3 System Management in Cardiothoracic Critical Care
- 3.1 CARDIOVASCULAR SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.2 RESPIRATORY SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.3 RENAL SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.4 HAEMATOLGY AND TRANSFUSION IN CARDIOTHORACIC CRITICAL CARE
- 3.5 GASTROINTESTINAL SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.6 IMMUNE SYSTEM AND INFECTION IN CARDIOTHORACIC CRITICAL CARE
- 39 The role of the immune system in critical illness
- 40 Sepsis and the systemic inflammatory response syndrome
- 41 Infection control
- 42 Infective endocarditis
- 3.7 ENDOCRINE SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.8 NEUROLOGICAL SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- SECTION 4 Procedure-Specific Care in Cardiothoracic Critical Care
- SECTION 5 Discharge and Follow-up From Cardiothoracic Critical Care
- SECTION 6 Structure and Organisation in Cardiothoracic Critical Care
- SECTION 7 Ethics, Legal Issues and Research in Cardiothoracic Critical Care
- Appendix Works Cited
- Index
39 - The role of the immune system in critical illness
from 3.6 - IMMUNE SYSTEM AND INFECTION IN CARDIOTHORACIC CRITICAL CARE
Published online by Cambridge University Press: 05 July 2014
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- SECTION 1 Admission to Critical Care
- SECTION 2 General Considerations in Cardiothoracic Critical Care
- SECTION 3 System Management in Cardiothoracic Critical Care
- 3.1 CARDIOVASCULAR SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.2 RESPIRATORY SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.3 RENAL SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.4 HAEMATOLGY AND TRANSFUSION IN CARDIOTHORACIC CRITICAL CARE
- 3.5 GASTROINTESTINAL SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.6 IMMUNE SYSTEM AND INFECTION IN CARDIOTHORACIC CRITICAL CARE
- 39 The role of the immune system in critical illness
- 40 Sepsis and the systemic inflammatory response syndrome
- 41 Infection control
- 42 Infective endocarditis
- 3.7 ENDOCRINE SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- 3.8 NEUROLOGICAL SYSTEM IN CARDIOTHORACIC CRITICAL CARE
- SECTION 4 Procedure-Specific Care in Cardiothoracic Critical Care
- SECTION 5 Discharge and Follow-up From Cardiothoracic Critical Care
- SECTION 6 Structure and Organisation in Cardiothoracic Critical Care
- SECTION 7 Ethics, Legal Issues and Research in Cardiothoracic Critical Care
- Appendix Works Cited
- Index
Summary
Introduction
The immune system has evolved to provide protection against invading pathogenic organisms, foreign cells and cancer cells. This chapter describes basic mechanisms involved in innate and acquired immune responses and describes the particular relevance for critical illness, notably sepsis and multiple organ dysfunction syndromes.
Innate immunity
Immunity is the state of protection from infectious disease or our own altered cells, and comprises both specific and nonspecific components. Nonspecific, or innate immunity, is the basic in-built resistance to disease and consists of four defensive barriers that offer protection through anatomical, physiological, phagocytic and inflammatory strategies.
Anatomical barriers
THE SKIN
Intact skin prevents the penetration of most pathogens. The thinner outer epidermis is renewed every 2 to 4 weeks and does not contain blood vessels. The thicker dermis is composed of connective tissue and contains blood vessels, hair follicles, sebaceous glands and sweat glands. The sebaceous glands produce the oily substance sebum, made up of lactic acid and fatty acids, which keeps the pH of the skin at around 4 to inhibit bacterial growth.
Breaks in the skin such as small cuts and insect bites are obvious routes of infection.
MUCOUS MEMBRANES
Many pathogens can enter the body by penetrating mucous membranes, although they are protected by saliva, tears and mucus, which wash away organisms and also contain antiviral and antibacterial substances.
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- Core Topics in Cardiothoracic Critical Care , pp. 301 - 309Publisher: Cambridge University PressPrint publication year: 2008