Multiple Organ Failure

Inflammation in itself is not to be considered as a disease . . . and in disease, where it can alter the diseased mode of action, it likewise leads to a cure; but where it cannot accomplish that solitary purpose . . . it does mischief - John Hunter, A Treatise on the Blood, ITfIlammation, and Gunshot Woundr (London, 1794)1 As we reached the millennium, we recognized the gap between our scientific knowledge of biologic processes and our more limited clinical capabilities in the care of patients. Our science is strong. Molecular biology is powerful, but our therapy to help patients is weaker and more limited. For this reason, this book focuses on the problems of multiple organ failure (MOF), multiple organ dysfunction syndrome (MODS), and systemic inflammatory response syndrome is, patients who have severe injuries; require major, (SIRS) in high-risk patients, that overwhelming operations; or have serious illnesses requiring intensive care; patients who have diseases elsewhere, in other organs or systems, that limit their capabilities to survive a new insult; and patients who are elderly or at high risk for sepsis or other complications. These are the patients who need our help. They need the advances in science, in molecular biology, immunology, pathophysiology, biochemistry, genetics, high technology, and other areas of maximum support at the bedside. These advances could potentially have the greatest impact on improving patient care.

The critical care unit manages patients with a vast range of disease and injuries affecting every organ system. The unit can initially be a daunting environment, with complex monitoring equipment producing large volumes of clinical data. Core Topics in Critical Care Medicine is a practical, comprehensive, introductory-level text for any clinician in their first few months in the critical care unit. It guides clinicians in both the initial assessment and the clinical management of all CCU patients, demystifying the critical care unit and providing key knowledge in a concise and accessible manner. The full spectrum of disorders likely to be encountered in critical care are discussed, with additional chapters on transfer and admission, imaging in the CCU, structure and organisation of the unit, and ethical and legal issues. Written by Critical Care experts, Core Topics in Critical Care Medicine provides comprehensive, concise and easily accessible information for all trainees.

Critical care practitioners are often the initial providers of care to seriously ill patients with infections. This book provides clinicians practicing in the intensive care unit with a reference to help guide their care of infected patients. It brings together a group of international authors to address important topics related to infectious diseases for the critical care practitioner.

In this book current knowledge of the pathophysiology of shock, sepsis and multi organ failure is presented. The rapid progress which has been made and the results achieved in intensive care medicine are based on sound basic research, which is duly reflected in these chapters. Multiorgan failure is the foremost cause of postoperative and posttraumatic death and many complex mechanisms are involved. Only with a good foundation of basic research can abnormalities in the physiological, biochemical, and morphological course of shock be recognized and the necessary conclusions for treatment drawn. Therapy must proceed from profound knowledge of the multi variant physiological events in order to influence shock, sepsis and organ failure. Although numerous possibilities for therapy have arisen from pharmaceutical research in recent years, they are beyond the scope of this book and are not discussed here. To gain a better understanding of the pathophysiological events it was necessary to examine and to describe different models that simulate and reproduce these events. Here we describe the causative agents (shock) and the consequences (sepsis, organ failure) in two main sections, divided on the basis of their pathophysiology.

This book is dedicated to the fundamental clinical signs of astute observation, careful differential diagnosis and analytical therapeutic decision-making in emergency veterinary settings. It clearly defines the physiological and clinical principles fundamental to the management of the critically ill small animal patient. With clear guidelines for organizing an emergency/critical care unit, the book also discusses ethical and legal concerns. The 80 expert authors have created a clinically specific resource for the specialist, residents in training, veterinary practitioners, technicians and students.Published by Teton New Media in the USA and distributed by CRC Press outside of North America.

Sepsis is a syndrome or sometimes it is a clinical condition evoked by uncontrolled endotoxin-reactions. These pathophysiological alterations can disturb the organism's homeostasis leading ultimately to a condition of severe organ dysfunction which in itself means a bad prognosis for patient survival. In the last decades researchers and clinicians have been involved in process directed to a better understanding of the basic mechanisms of sepsis and MODS. The best goal will be the achievement of preventive measures and optimization of management in patients suffering severe infections and critical conditions. This objective represents a true challenge at the dawn of the XXI century.