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Cited by 287Sepsis Diagnosis and TreatmentComplex Systems and DynamicsInflammation biomarkers and pathways

Multiple organ dysfunction syndrome: exploring the paradigm of complex nonlinear systems

Seely, Andrew J. E., Christou, Nicolas V.·2000·Critical Care Medicine
DOI 10.1097/00003246-200007000-00003
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Abstract

OBJECTIVES: The objectives of this article are to introduce and explore a novel paradigm based on complex nonlinear systems, and to evaluate its application to critical care research regarding the systemic host response and multiple organ dysfunction syndrome (MODS). DATA SOURCES: Published original work, review articles, scientific abstracts and books, as well as our personal files. STUDY SELECTION: Studies were selected for their relevance to the applications of nonlinear complex systems, to critical care medicine, and to the concepts presented. DATA EXTRACTION: We extracted all applicable data. DATA SYNTHESIS: Following a brief review of MODS, an introduction to complex nonlinear systems is presented, including clear concepts, definitions, and properties. By examining the multiple, nonlinear, interrelated, and variable interactions between the metabolic, neural, endocrine, immune, and inflammatory systems; data regarding interconnected antibody networks; and the redundant, nonlinear, interdependent nature of the inflammatory response, we present the hypothesis that the systemic host response to trauma, shock, or sepsis must be evaluated as a complex nonlinear system. This model provides a new explanation for the failure of trials using various antimediator therapies in the treatment of patients with sepsis and MODS. Understanding the host response as a complex nonlinear system offers innovative means of studying critical care patients, specifically by suggesting a greater focus on systemic properties. We hypothesize that analysis of variability and connectivity of individual variables offer a novel means of evaluating and differentiating the systemic properties of a complex nonlinear system. Current applications of evaluating variability and connectivity are discussed, and insights regarding future research are offered. CONCLUSION: The paradigm offered by the study of complex nonlinear systems suggests new insights to pursue research to evaluate, monitor, and treat patients with MODS.

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Crossref · 10.1097/00003246-200007000-00003

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59 of 59 references verified0 citation errors · 0 not checkable

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  • The pathogenesis of gut-derived sepsis is multifactorial, replete with biological redundancy.

    “the pathogenesis of gut-derived sepsis, like most processes in critical illness, is multifactorial, replete with biological redundancy.”

    From The microbiome and critical illness (2016) · cites this paper as [107]

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Related

Authors
Seely, A. J. E., & Christou, N. V.
Affiliations
McGill University Health Centre (CA)
ORCID
Seely, Andrew J. E.
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2000-07
Volume
28
Issue
7
Pages
2193-2200
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/00003246-200007000-00003
OpenAlex
W2028553295
Cited by
287
References
59
Citations by year
2026: 4 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 9 · 2021: 7 · 2020: 9 · 2019: 8 · 2018: 7 · 2017: 9 · 2016: 6 · 2015: 14 · 2014: 9 · 2013: 18 · 2012: 16
FWCI
2.20
Type
journal article
Language
en
Open access
closed
Locations
  • Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Physical Sciences › Physics and Astronomy › Statistical and Nonlinear Physics › Complex Systems and Dynamics
  • Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
Keywords
multiple organ failure, complex nonlinear systems, sepsis, shock, trauma (physical injury), inflammation, intensive care monitoring
MeSH terms
Critical Care, Heart Rate, Humans, Multiple Organ Failure, Nonlinear Dynamics

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