Management of Dysregulated Immune Response in the Critically Ill

This book, part of the European Society of Intensive Care Medicine (ESICM) textbook series, deals with dysregulated host response a relatively new term introduced by the Sepsis-3 definitions in 2016. In contrast to systemic inflammatory response syndrome (SIRS) that has been used for nearly 30 years, this is a fundamentally new concept, which requires some sort of a paradigm shift in the way of thinking of critical care physicians. This change obviously requires time and after 5 years, time is ripe to summarize the knowledge in the form of a comprehensive book.

The book is split in 4 sections. In the first one, the host immune response is explained in 11 chapters, followed by the next part, summarizing the possible tools for assessment at the bedside. The third and the fourth parts focus on the effects of dysregulated immune response on vital organ function and on the possible ways of immunomodulation. Written by internationally acclaimed experts of the field, the bookis of value for all those intensivists and allied professionals working in ICUs.

Foreword.- Preface.- Part I. The Host Immune Response.- Phenotypes.- The Dysregulated Host Response.- What is Cytokine Storm?.- Hemophagocytic Lymphohistiocytosis.- Extracorporeal Circulation Related Immune response.- Vasoplegic Shock.- Part II. Assessing Dysregulated Immune Response at the Bedside.- Pro- and anti-inflammatory biomarkers.- How to interpret procalcitonin?.- Assessment of the macro-, and microcirculation.- Part III. Dysregulated Immune Response and organ dysfunction.- Heart and circulation.- Brain.- Kidneys.- Liver.- Hemostasis.- The muscles.- Part IV. Modulating the immune response.- The Role of Steroids.- Why did Anti-Cytokine Therapies Fail in the Past?.- Extracorporeal cytokine removal.

Prof. Maurizio Cecconi is Head of Department Anaesthesia and Intensive Care Units, IRCCS Istituto Clinico Humanitas, Rozzano (MI), Italy and Professor of Anaesthesia and Intensive Care, Humanitas University, Pieve Emanuele (MI), Italy. His main fields of research are haemodynamic monitoring, haemodynamic optimisation and physiology of the critically ill patient. He has published extensively and has specific interest in haemodynamic monitoring and fluid management of the critically ill.

Prof. Daniel De Backer is Professor of Intensive Care at the Université Libre de Bruxelles, Brussels, Belgium Head of Intensive Care Departments of CHIREC Hospitals (Brussels and Braine l’Alleud-Waterloo). His main fields of investigation are severe sepsis, organ dysfunction, acute circulatory failure and its treatment (in particular vasoactive agents), haemodynamic monitoring, hepato-splanchnic circulation and microcirculatorydisorders.

Volume Editors

Zsolt Molnar is a professor in anaesthesiology and intensive therapy. Currently he holds a full professorship at the Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary and a part time professorship at the Department of Anaesthesiology and Intensive Therapy at the Poznan University of Medical Sciences, Poznan, Poland. He is also a Senior Medical Director at CytoSorbents Europe, Berlin, Germany. He has published extensively in the fields of sepsis related hemodynamic changes, fluid therapy, markers of inflammation, extracorporeal cytokine removal in hyperinflammation, oxygen debt and perioperative intensive care.

Marlies Ostermann is a Professor of Intensive Care and consultant in critical care and nephrology at Guy’s and St Thomas’ NHS Foundation Trust, London. She is also the departmental Research and Delivery lead and Director of Research of the Intensive Care Society,UK. Her research interest focusses on all aspects of acute kidney injury (kidney failure) and critical care nephrology. 

Manu Shankar-Hari is Chair of Translational Critical Care Medicine at The University of Edinburgh, Edinburgh, UK. Manu's research programme aims to enable precision immunomodulation in critically ill adults with sepsis and acute respiratory distress syndrome (ARDS).