SIRS, Sepsis, CARS, ARDS: Understanding different aspects of the inflammatory response in intensive care patients

Activation of the innate immune system is associated with an inflammatory reaction controlled by compensatory anti-inflammatory mechanisms. Failure of this control leads to a stereotyped clinical picture, SIRS and to severe organ dysfunctions such its septic shock and ARDS. Better understanding of the pathophysiological underlying mechanisms as provided opportunities to explore new ways of modulation of the inflammatory response. Unfortunately, results have been so far disappointing. A more precise selection of patients and of the timing of intervention may provide a greater efficacy of these treatments. Pharmaconutrition, by modifying cellular membranes lipid content and eicosanoids' production, offers all interesting alternative way. (C) 2009 Elsevier Masson SAS. All rights reserved.