Year in review 2010: Critical Care - multiple organ dysfunction and sepsis

Etienne De Montmollin,Djillali Annane

doi:10.1186/cc10359

Abstract

This review summarizes new insights in the pathophysiologic implications of inflammation and microvascular alterations in organ dysfunction, as well as genetic factor contribution, from clinical and experimental studies that were published in 2010 in Critical Care in the fields of multiple organ dysfunction and sepsis. New diagnostic and prognostic markers of organ dysfunction are presented. Evaluations of novel therapeutic strategies, including implementation of international guidelines, modulation of inflammation and coagulation, and prevention of ventilator-induced lung injury and acute kidney injury, are reported. The results of these experimental studies and clinical trials are discussed in the context of the current relevant scientific and clinical background.

Highlights

Multiple organ failure, or multiple organ dysfunction syndrome (MODS), was defined by the 1991 Consensus Conference of the American College of Chest Physicians and the Society of Critical Care Medicine as ‘the presence of altered organ functions in an acutely ill patient such that homeostasis cannot be maintained without intervention’ [1]
Our aim was to review the relevant findings of research articles that were published in 2010 in Critical Care and that focused on advances in the understanding of MODS physiopathology, diagnostic and prognostic marker evaluation, and novel therapy strategies
Inflammation, septic microvascular dysfunction, and multiple organ dysfunction syndrome It is well established that the correction of macrovascular hemodynamic parameters is not sufficient to prevent MODS in sepsis and that persistent microvascular alteration is associated with the development of organ dysfunction and death [4]

Summary

Introduction

Multiple organ dysfunction syndrome (MODS), was defined by the 1991 Consensus Conference of the American College of Chest Physicians and the Society of Critical Care Medicine as ‘the presence of altered organ functions in an acutely ill patient such that homeostasis cannot be maintained without intervention’ [1].

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Results

Conclusion