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- W2892317792 endingPage "1552.e10" @default.
- W2892317792 startingPage "1536" @default.
- W2892317792 abstract "A successful immune response is critically necessary to eradicate infectious challenges and prevent dissemination of the infection in the host. However, if inflammation is not limited and becomes generalized, it can result in the constellation of signs and symptoms of a systemic inflammatory response syndrome (SIRS). If the infection is not contained, the spread of the pathogen from its local origin through the blood may result in systemic endothelial activation and precipitate sepsis, severe sepsis, and septic shock. Progression of sepsis to shock may lead to multiple organ dysfunction syndrome (MODS) and ultimately death.Host immunity is divided into innate and adaptive immune systems for purposes of discussion and teaching but there is a great deal of interaction between the two systems. Innate immunity is rapid, largely nonspecific, and composed of barriers, phagocytic cells, the complement system, and other soluble components of inflammation. After breech of a barrier, cellular elements of the innate immune response are the first line of defense against the development and progression of infection. Adaptive immunity, which is antigen specific, is long lived, and often takes several days to develop, provides immunologic specificity and memory. These systems work together to protect the host from pathogenic challenge but may also precipitate host injury through aberrant responses. The outcome of infection is dependent on at least four major factors: (1) the pathogen, (2) the pathogen load, (3) the site of infection, and (4) the host response. Less is known about the host response in neonates compared with adults for a number of reasons, the principal one being a highly variable definition of disease.Our understanding of the pathophysiology of sepsis is largely from investigations in adult populations, including both humans and animals. There is clear evidence from both preclinical models of sepsis and humans that neonates manifest different host immune responses as compared with adults.1, 2, 3, 4 Even in comparison with children, neonates manifest a unique host immune response to septic shock.5 Thus neonatal-specific clinical investigations, particularly in very preterm infants, are required to improve both survival and long-term outcomes for these populations. A better understanding of the pathophysiology will uncover new opportunities for interventional studies ultimately aimed at improving outcomes. To this end, in this chapter we explore the pathophysiology of sepsis in the neonate, with special attention paid to the immunobiology of sepsis." @default.
- W2892317792 created "2018-09-27" @default.
- W2892317792 creator A5020609229 @default.
- W2892317792 creator A5035778553 @default.
- W2892317792 date "2017-01-01" @default.
- W2892317792 modified "2023-09-30" @default.
- W2892317792 title "Pathophysiology of Neonatal Sepsis" @default.
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