Abstract
Giorgio Noera1* and Alfio Bertolini2 Author Affiliations 1Maria Cecilia Hospital, GVM Care & Research Cardiac Surgery Unit, Italy 2Late Professor and Chairman, Department of Medicine and Division of Clinical Pharmacology, School of Medicine of the University of Modena and Reggio Emilia, Italy Received: August 22, 2020 | Published: August 31, 2020 Corresponding author: Giorgio Noera, Maria Cecilia Hospital, GVM Care & Research Cardiac Surgery Unit, Italy DOI: 10.26717/BJSTR.2020.29.004870
Highlights
Exposure to all causes that trigger shock status are marked out by immunological unique time-related host response against inadequate oxygen delivery to tissues
The tissue hypoperfusion/hypoxia triggers, if not promptly corrected, an overamplified cascade of events that leads to multiple organ failure and death
The treatment with naloxone, and more in general with opiate antagonists, in the idea that a massive release of endogenous opioids plays a central role in the pathogenesis of shock and in its catastrophic slipping into multiple organ failure, was initially rather enthusiastically endorsed, in view of the results in animal studies, but was at the end abandoned, in the light of several inconsistencies
Summary
Exposure to all causes that trigger shock status are marked out by immunological unique time-related host response against inadequate oxygen delivery to tissues. The multiple organ dysfunction syndrome (MODS) and the multi organ failure (MOF) are marked out by time-related host response from a lifethreatening status to death. On the contrary, obesity-related pathologies, infectious diseases, and malignancies, MOF represents one of the leading causes of mortality worldwide. Despite the tremendous social impact and despite the huge number of experimental and clinical studies, the progress in both prevention and treatment of this dramatic clinical condition has been very limited. Some conceptually innovative first-aid treatments have been proposed during the last decades, either with -at the end- disappointing results following an initial enthusiasm or with incredulity and non-consideration
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