[Inflammation and perioperative organ dysfunction]

The immune system is an effective defense against invading pathogens and is accompanied by recruitment of immune cells and initiation of an inflammatory reaction. This can also be triggered by noninfectious stimuli, e.g. a large surgical intervention and cause severe tissue destruction and organ dysfunction. The organism cannot distinguish many stimuli that are released during a large surgical intervention from exogenous pathogens. Therefore, there is a high risk for the occurrence of systemic inflammatory reactions, particularly in large surgical interventions. This excessive immune response leads to release of proinflammatory cytokines, endothelial dysfunction, damage to the glycocalyx, activation of leukocytes as well as tissue and organ destruction. This article summarizes the molecular principles of the surgery-associated inflammatory reaction, the differentiation from other inflammatory complications and treatment options.