Multiple organ failure

Value of SOD for prevention of multiple organ failure after multiple trauma. J. Trauma 35, 110—113. 

Heat shock proteins (HSPs) are synthesized by cells in response to an increase in temperature, as well to various other stressful stimuli. Their main function is to ensure intracellular protein homeostasis, thus preserving the cells viability in the presence of aggression. Current evidence points to a protective role for HSPs in several aspects of critical disease, such as ischemia-reperfusion, ARDS, and multiple organ failure. The increase of a few degrees Celsius above the normal environmental temperature of cells leads to the heat shock response 1) rapid expression of heat shock genes, 2) suppression of normal protein synthesis, and 3) the ability of cells to survive a second and otherwise lethal heat challenge (thermotolerance). 

Cyclooxygenase Inhibitors. The synthesis of prostaglandin and thromboxane has been linked with multiple organ failure in animals and humans with sepsis. Bernard et al. (B18) reported the results of a large trial of the cyclooxygenase inhibitor ibuprofen in patients with sepsis. Treatment for 48 hours with... 

A5. Anderson, B. O., Bensard, D. D., and Harken, A. H The role of platelet activating factor and its antagonists in shock, sepsis and multiple organ failure. Surg. Gynecol. Obstet. 172,415-424 (1991). 

Ou, M. C., Kambayashi, J., Kawasaki, T., Ueraura, Y., Shinozaki, K., Shiba, E Sakon, M Yukawa, M and Mori, T Potential etiologic role of PAF in two major septic complications disseminated intravascular coagulation and multiple organ failure. Thromb. Res. 73, 227-238 (1994). 

Z6. Zimmermann, T., Laszik, Z., Nagy, S., Kaszaki, J., and Joo, F The role of the complement system in pathogenesis of multiple organ failure in shock. Prog. Clin. Biol. Res. 308, 291-297 (1989). 

Chronic Health Evaluation II >25, sepsis-induced multiple organ failure, septic shock, or sepsis-induced acute respiratory distress syndrome)... 

Some patients fail to recover from trauma because they develop multiple organ failure (MOF), also known as multiple systems failure (MSF). It is estimated to kill almost 200000 patients each year in the USA. The name arises from the fact that several organs are involved and they are distant from the site of trauma. Since it can arise in septic patients, it is also known as septic shock syndrome . It can occur in any condition that induces a major inflammatory response. The time between the insult and the malfunction of the organs is variable and may run into weeks. As expected, the larger the number of organs involved, the greater the risk of death (Box 18.1). 

So far there are no satisfactory treatments for multiple organ failure, although steroids are sometimes used to inhibit the activity of the immune system. Provision of antibodies to one or more of the proinflammatory cytokines is one novel approach. 

Renal dysfunctions can be diagnosed by different methods, depending on the severity of the condition. Examination of urine, which is produced by the kidneys, provides an important indication of renal insufficiency. The urine output, color, odor, acidity, specific gravity, and constituents are important prognostic factors of kidney status. However, in critically ill patients and in acute renal failures induced by several diseases including multiple organ failures and diabetes, urine examination may be impractical and redundant. Such patients require reliable and simple methods to diagnose the onset of renal failure. 

Excess serotonin in the central nervous system leads to a condition commonly referred to as the serotonin syndrome. There are several drug mechanisms that can cause serotonin toxicity. Serotonin toxicity can be a medical emergency characterised by rapid onset of severe hyperthermia, muscle rigidity and multiple organ failure. 

Hsu, D. Z., and M. Y. Liu. Sesame oil attenuates multiple organ failure and increases survival rate during endotoxemia in rats. Critic Care Med... 

Abelcet-. Chills, fever, increased serum creatinine, multiple organ failure AmBisome-. Hypokalemia, hypomagnesemia, hyperglycemia, hypocalcemia, edema, abdominal pain, back pain, chills, chest pain, hypotension, diarrhea, nausea, vomiting, headache, fever, rigors, insomnia, dyspnea, epistaxis, increased liver/renal function test results... 

Vision and hearing alterations, seizures, liverfailure, coagulation defects, multiple organ failure, and sepsis maybe noted. 

Prior to inclusion of hemosorption in therapy, all patients were in a poor condition due to severe endogenous intoxication and circulatory injury. 376 patients had a stable blood circulation and 64 had a reduced circulation of the blood. All patients had dynamic ileus, and 88 patients had acute multiple organ failure. A special feature of biochemical alterations was imbalance of the protease-inhibitor system. It was manifested in a significant elevation of TLA in blood plasma (P< 0.001) and decrease of a -PI and a -M concentrations (P< 0.001). The decrease of total protein and albumin, and the increase of urea and MM levels (P<0.001) were also characteristic for protein metabolism injury. 

The discrepancy of literature data and the urgency of this problem have induced us to study the hemosorption effects of the modified sorbents on the condition of patients with multiple organ failure. 

The immune system of patients with postoperative multiple organ failure is compromised, which is confirmed by the decrease of immunocompetent cells but not immunoglobulins IgA and IgM. Nonspecific immunity of these patients is also depressed. However, after extracorporeal blood purification had been performed, immune system stimulation was observed, which was higher than hemosorption specific indicators of cellular and humoral immunity. 

Durham RM, Moran JJ, Mazuski JE, Shapiro MJ, Baue AE, Flint LM (2003) Multiple organ failure in trauma patients. J Trauma 55(4) 608-616 Eckle T, Grenz A, Laucher S, Eltzschig HK (2008) A2B adenosine receptor signaling attenuates acute lung injury by enhancing alveolar fluid clearance in mice. J Clin Invest 118(10) 3301-3315... 

A non-diabetic 25-year-old woman died after 2 days of lactic acidosis and multiple organ failure, having taken an unknown amount of her father s metformin (58,131). 

Belluck, D.A., Benjamin, S.L., Baveye, P. et al. (2003) Widespread arsenic contamination of soils in residential areas and public spaces an emerging regulatory or medical crisis . International Journal of Toxicology, 22(2), 109-28. Bollinger, C.T., van Zijl, P. and Louw, J.A. (1992) Multiple organ failure with the adult respiratory distress syndrome in homicidal arsenic poisoning. Respiration, 59, 57-61. 

Ikei, S., Ogawa, M., and Yamaguchi, Y., Blood concentrations of polymorphonuclear leucocyte elastase and interleukin-6 are indicators for the occurrence of multiple organ failures at early stage of acute pancreatitis. J. Gastroenterol. Hepatol. 13,1274-1283 (1993). 

R13. Romaschin, A. D., De Majo, W. C., Winton, T., D Costa, M., Chang, G., Rubin, B., Gamliel, Z., and Walker, P. M., Systemic phospholipase a2 and cachectin levels in adult respiratory distress syndrome and multiple-organ failure. Clin. Biochem. 25,55—60 (1992). 

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