Hemorrhage and resuscitation: Immunological aspects

Although numerous studies concerning the etiology of immunosuppression following various forms of trauma are being carried out, relatively little attention has been directed toward addressing the issue of whether simple hemorrhage per se plays any major role in producing the immunosuppression. The available information indicates tht even transient hypotension in the absence of any significant tissue trauma produces a marked depression in both the specific and nonspecific cell-mediated immunity. Although the precise mechanisms responsible for producing the immunodepression after simple hemorrhage and resuscitation remain unknown, the depression of macrophage antigen presentation, as well as the enhanced capacity of Kupffer cells to produce TNF, may play an important role in initiating cell and organ dysfunction and in contributing to the host's enhanced susceptibility to sepsis after hemorrhage.