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Chronic inflammation is a prolonged, dysregulated immune response that persists for weeks to years when the inciting stimulus is difficult to eradicate or when self‑antigens drive ongoing reactivity. Morphologically, it is defined by mononuclear cell infiltration, progressive tissue destruction, and concurrent attempts at healing via angiogenesis and fibrosis. Compared with acute inflammation, edema is less prominent while cellular infiltration predominates; triggers include persistent...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Systemic inflammation in the elderly.

Emily G Y Koo1, Linda M L Lai, Gordon Y S Choi

  • 1Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region. emilykoo@cuhk.edu.hk

Best Practice & Research. Clinical Anaesthesiology
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PubMed
Summary
This summary is machine-generated.

Systemic inflammatory response syndrome (SIRS) after surgery affects 10-15% of elderly patients. Early recognition and prompt resuscitation are key to managing this potentially dangerous over-reactive inflammation.

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Area of Science:

  • Surgery
  • Inflammation
  • Critical Care Medicine

Background:

  • Postoperative systemic inflammation, a common complication, arises from unregulated pro-inflammatory responses.
  • Systemic inflammatory response syndrome (SIRS) affects 10-15% of elderly patients undergoing major surgery.
  • While infections are a primary cause, trauma and hemorrhage also contribute significantly to SIRS.

Purpose of the Study:

  • To highlight the prevalence and risk factors of postoperative systemic inflammation in elderly surgical patients.
  • To emphasize the importance of increased awareness, risk factor modification, and early recognition in managing SIRS.
  • To underscore the need for prompt resuscitation and further research into SIRS in this demographic.

Main Methods:

  • Review of existing literature on postoperative systemic inflammation.
  • Analysis of predisposing risk factors including extent of trauma and hemorrhage.
  • Discussion of current management strategies and future research directions.

Main Results:

  • Postoperative systemic inflammation is more common than generally acknowledged, particularly in elderly surgical patients.
  • Infections are the main cause, but trauma and hemorrhage are significant contributing factors.
  • Early recognition and prompt resuscitation (correcting hypotension, hypovolemia, tissue hypoxia) can improve outcomes.

Conclusions:

  • Increased awareness, risk factor modification, and early recognition are crucial for managing SIRS.
  • Prompt resuscitation is vital for improving patient outcomes.
  • Further large prospective studies are needed to define SIRS incidence, risk factors, and impact in elderly surgical patients, alongside research into molecular mechanisms for immunotherapy development.