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Multiple-Organ Failure: Generalized Autodestructive Inflammation?
Abstract
As multiple-organ failure (MOF) has been generally associated with sepsis, the importance of bacterial sepsis was evaluated retrospectively in 55 trauma and 37 intra-abdominal-sepsis patients with MOF. The severity of MOF was graded, and an analysis was made of day of onset, incidence, severity, sequence, and mortality of organ failures. No difference was found between groups in sequence, severity, or mortality of organ failures. In contrast, bacterial sepsis was found in 65% of intra-abdominal-sepsis patients but only in 33% of trauma patients. It is concluded that sepsis is probably not the essential cause of MOF. Instead, an alternative hypothesis is presented involving massive activation of inflammatory mediators by severe tissue trauma or intra-abdominal sepsis, resulting in systemic damage to vascular endothelia, permeability edema, and impaired oxygen availability to the mitochondria despite adequate arterial oxygen transport.
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Antonelli, M., Conti, G., Rocco, M., Bufi, M., De Blasi, R. A., Vivino, G., Gasparetto, A., & Meduri, G. U. (1998) · New England Journal of Medicine · doi:10.1056/nejm199808133390703 · Cited by 1,014
Keel, M., & Trentz, O. (2005) · Injury · doi:10.1016/j.injury.2004.12.037 · Cited by 885
Postinjury Multiple Organ Failure: A Bimodal Phenomenon
Moore, F. A., Sauaia, A., Moore, E. E., Haenel, J. B., Burch, J. M., & Lezotte, D. C. (1996) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-199604000-00001 · Cited by 491
Tanaka, H. (2000) · Archives of Surgery · doi:10.1001/archsurg.135.3.326 · Cited by 438
Gut-origin sepsis: evolution of a concept
Deitch, E. A. (2012) · The Surgeon · doi:10.1016/j.surge.2012.03.003 · Cited by 359
Dünser, M. W., Mayr, A. J., Tür, A., Pajk, W., Barbara, F., Knotzer, H., Ulmer, H., & Hasibeder, W. R. (2003) · Critical Care Medicine · doi:10.1097/01.ccm.0000059722.94182.79 · Cited by 250
Gut-origin sepsis in the critically ill patient: pathophysiology and treatment
Assimakopoulos, S. F., Triantos, C., Thomopoulos, K., Fligou, F., Maroulis, I., Marangos, M., & Gogos, C. A. (2018) · Infection · doi:10.1007/s15010-018-1178-5 · Cited by 244
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Silvestri, L., van Saene, H. K. F., Zandstra, D. F., Marshall, J. C., Gregori, D., & Gullo, A. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181d9db8c · Cited by 78
Adachi, N., Hirota, M., Hamaguchi, M., Okamoto, K., Watanabe, K., & Endo, F. (2004) · Clinica Chimica Acta · doi:10.1016/j.cccn.2003.12.011 · Cited by 70
Mediators of multiple organ failure
Goris, R. J. A. (1990) · Intensive Care Medicine · doi:10.1007/bf01709699 · Cited by 67
Self-citation
Metadata
- Authors
- Goris, R. J. A.
- Venue
- Archives of Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 1985-10-01
- Volume
- 120
- Issue
- 10
- Pages
- 1109
- ISSN
- 0004-0010 (ISSN-L)
- OpenAlex
- W2004536137
- Cited by
- 1,289
- References
- 0
- FWCI
- 14.92
- Type
- journal article
- Language
- en
- Open access
- closed
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