Liver-Lung Interactions in ARDS with MOF

Abstract

Multiple organ failure is a complex process occurring in up to 15% of patients in the intensive care unit (ICU) after initially successful resuscitation from severe infection, generalized activation of acute inflammatory responses (e. g. acute pancreatitis), or trauma [1–4]. Recently, this process has been termed the multiple organ dysfunction Syndrome (MODS), in view of the difficulties in distinguishing organ dysfunction from “failure” [1–3]. Despite application of progressively sophisticated diagnostic techniques and supportive care, the incidence of MODS is rising. More patients are elderly and immunocompromised, and undergo increasingly invasive procedures or therapeutic immunosuppression [1]. Case-specific mortality rates still ränge from 60–100% depending on patient age, pre-existing health status, number of organ systems involved, and the duration of organ impairment [3, 4]. Numerical aspects of organ dysfunction during MODS are strongly associated with mortality, independent of individual organ Performance [4]. However, the attendant notion of “organ equivalence” is no longer tenable with respect to their susceptibility to injury, involvement in systemic host defense regulation, and role in inducing cellular injury in remote organ systems owing to inappropriately regulated host responses.