Advertisement

Update 1989 pp 15-23 | Cite as

Role of Neutrophils and Macrophages in Multiple Organ Failure

  • N. V. Christou
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 8)

Abstract

In the late 1960s and early 1970s terms like “shock lung”, “Da Nang lung” and “Adult Respiratory Failure” became common in the literature and at rounds in the intensive care unit. Along with abnormalities in pulmonary function, there was renal failure and jaundice and a clinical syndrome was recognized which consisted of the following: persistent fever; tachycardia; high cardiac output associated with normal filling pressures and low peripheral resistance; tachypnea; requirement for ventilatory support; ileus; jaundice; necessity for dialysis. This clinical syndrome has come to be recognized and named Multiple Organ Failure (MOF). Subsequent to the initial report of MOF, it was suggested that the presence of MOF is indicative of occult sepsis which often leads to the recommendation for a laparotomy [1]. The precipitating factor(s) of MOF included shock, infection, massive trauma, burn injury and hematoma. MOF remains the predominant reason for both prolonged stay and death in the surgical intensive care unit. What was perceived as isolated organ failure, such as adult respiratory distress syndrome, is now seen as part of the systemic response to injury and repair. Sepsis has become the systemic inflammatory response due to invading microorganisms. What was once perceived as diagnostic of sepsis, has now been recognized after severe perfusion deficits and in the presence of continuing sources of dead and injured tissue.

Keywords

Kupffer Cell Acute Phase Protein Acute Phase Response Adult Respiratory Distress Syndrome Surgical Intensive Care Unit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Krause R (1987) Reintervention in abdominal surgery. World J Surg 11:226–232PubMedCrossRefGoogle Scholar
  2. 2.
    Cerra FB (1987) The hypermetabolism organ failure complex. Surgery 101:1–14PubMedGoogle Scholar
  3. 3.
    Dinarello CA (1984) Interleukin-1. Rev Infect Dis 6:51–95.PubMedCrossRefGoogle Scholar
  4. 4.
    Dinarello CA (1984) Interleukin-1 and the pathogenesis of the acute-phase response. N Engl J Med 311:1413–1418PubMedCrossRefGoogle Scholar
  5. 5.
    Goldberg BS, Weston WL, Kohler PF, et al (1979) Transcutaneous leukocyte migration in vivo: Cellular kinetics, platelets and C5a dependent activity. J Invest Dermatol 72:248PubMedCrossRefGoogle Scholar
  6. 6.
    Porter RR (1981) Interactions of complement components with antibody-antigen aggregates and cell surfaces. Immunol Today 2:143CrossRefGoogle Scholar
  7. 7.
    Atkins E, Bodel P, Francis L (1967) Release of an endogenous pyrogen in vitro from rabbit mononuclear cells. J Exp Med 126:357–361PubMedCrossRefGoogle Scholar
  8. 8.
    Rosenthal AS (1980) Regulation of the immune response-role of the macrophage. N Engl J Med 303:1153–1156PubMedCrossRefGoogle Scholar
  9. 9.
    Van Oss CS, Absolom DR, Moore LL (1980) Effect of temperature on the chemotoxis, phagocytic engulgfment, digestion and O2 consumption of human polymorphonuclear leukocytes. J Reticuloendothel Soc 27:561–568PubMedGoogle Scholar
  10. 10.
    Dinarello CA (1984) Interleukin-1 and the pathogenesis of the acute phase response. N Engl J Med 311:1413–1418PubMedCrossRefGoogle Scholar
  11. 11.
    Beutler B, Cerami A (1987) Cachectin: More than a tumor necrosis factor. N Engl J Med 316:379–385PubMedCrossRefGoogle Scholar
  12. 12.
    Nuytinck JK, Goris RJ, Weerts JG, Schillings PH, Stekhoven JH (1986) Acute generalized microvascular injury by activated complement and hypoxia: the basis of the adult respiratory distress syndrome and multriple organ failure? Br J Exp Pathol 67:537–548PubMedGoogle Scholar
  13. 13.
    Meakins JL, Marshall JG (1986) The GI tract: The motor of multiple organ failure. Arch Surg 121:197–201Google Scholar
  14. 14.
    Keller GA, West MA, Cerra FB, Simmons RL (1985) Macrophage-mediated modulation of hepatic function in multiple-system failure. J Surg Res 39:555–563PubMedCrossRefGoogle Scholar
  15. 15.
    Driks MR, Craven DE, Celli BR, et al (1987) Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. The role of colonization. N Engl J Med 317:1376–1382PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • N. V. Christou

There are no affiliations available

Personalised recommendations