caa a22 4500 47703571X CHVBK 20180405111304.0 cr unu---uuuuu 170330e19960501xx s 000 0 eng 10.1007/s002689900068 doi (NATIONALLICENCE)springer-10.1007/s002689900068 Ingredients of Organ Dysfunction or Failure [Elektronische Daten] [A. Gullo, G. Berlot] Abstract. The simultaneous dysfunction of several organs (MODS, or multiple organ dysfunction) represents the most challenging task for the intensivist. In recent years more and more patients have been diagnosed as suffering from MODS due to several causes, including better immediate treatment of injuries that only a few years ago would have been considered incompatible with life or with consequent reduced organ reserve. Even if initially MODS has been associated with infections and sepsis, because of its similarity with a generalized inflammatory reaction mediated by a wide array of mediators, it is now clear that noninfectious insults, such as multiple trauma, acute pancreatitis, and retroperitoneal bleeding, can start a chain reaction ultimately leading to the onset of MODS. A specific trigger factor has not yet been identified, but experimental and clinical evidence suggests that the gut, endothelium, and immune system interact to produce the altered metabolic and cardiorespiratory patterns commonly observed in patients with MODS. It is thus possible that a target-oriented approach, including rapid correction of intestinal underperfusion, supply of specific nutrients, and down-regulation of the inflammatory cascade, can act as either a preventive measure for subjects at risk or as a main treatment for patients with full-blown MODS.: 1996 by the Société Internationale de Chir, ugie Gullo A. Department of Anesthesia and Intensive Care, University Medical School, 34100 Trieste, Italy, IT aut Berlot G. Department of Anesthesia and Intensive Care, University Medical School, 34100 Trieste, Italy, IT aut https://doi.org/10.1007/s002689900068 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900068 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gullo A. Department of Anesthesia and Intensive Care, University Medical School, 34100 Trieste, Italy, IT aut NATIONALLICENCE 700 1- Berlot G. Department of Anesthesia and Intensive Care, University Medical School, 34100 Trieste, Italy, IT aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer