Immune-Inflammatory Disorders in the ICU

Critical illnesses are frequently associated with and complicated by immune-inflammatory disorders, either as preexisting comorbidities or new diseases exacerbated by critical care status. Systemic manifestations of preexisting immune-inflammatory disorders can become serious life-threatening conditions, thus requiring ICU support. Apart from these systemic immune-inflammatory disorders, hyperinflammatory response to a trigger such as sepsis, infection, or malignancy may occur and result in widespread clinical consequences. Treatment strategies of systemic immune-inflammatory disorders are based on the type of diseases and aim to downregulate an overreactive immune system and to control the clinical manifestations of these disorders. Steroids, disease-modifying antirheumatic drugs, nonsteroidal anti-inflammatory drugs, and the new biologic disease-modifying agents are usually used for treatment. The aim of this chapter is to briefly characterize and discuss the intensive care management of immune-inflammatory diseases that can affect critically ill patients.