Posttraumatic Multisystem Organ Failure

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Abstract
THE SYNDROME of multisystem organ failure (MSOF) currently affects a wide variety of critically ill or injured patients. The mortality rate is well in excess of 60%. Its natural course requires long stays in the intensive care unit and consumes excessive monetary, physician, and hospital resources. The emergence of MSOF is directly related to improvements in organ system support and monitoring, which have made it possible to sustain previously lethal critical illness. The syndrome is characterized by a hyperdynamic, hypermetabolic state identical to that seen in sepsis. The term sepsis syndrome also is used to reflect the fact that infection, although frequently present, is not essential for initiating or perpetuating progressive organ failure. A systemic inflammatory response modulated by a cascade of soluble protein and lipid mediators seems to be the final common pathway linking the sepsis syndrome with MSOF. Herein, we review the origin and presentation of MSOF and

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