Step (or leap) into the future. What is new in 2000 and beyond? An emphasis on endocrine failure

  • A. E. Baue
Conference paper


This paper is my annual oration on prevention of multiple organ dysfunction syndrome (MODS) and multiple organ failure (MOF) at the Organ Failure Academy in Trieste, Italy. All we can do to treat MODS and MOF is organ support. Therefore, prevention is the key — supporting organ and system function before dysfunction or failure occur. There are many ways we can do that in 2002.1 have reviewed them [1,2]. The future was predicted recently by a number of authorities in intensive care medicine and anaesthesiology who were plenary speakers at the recent Society of Critical Care Medicine meeting. Buchman talked about the new junction of genomics and critical care as it exists today and as it is likely to evolve tomorrow, van der Pol reviewed tissue factor and activated protein C, which may also improve other inflammatory pathways. Abraham reviewed genetic analyses and predicted that they may help determine future therapies in critically ill patients. Tracy said that it should be feasible to study both vagus nerve stimulation and anti-HMGB-1 (a latent mediator). Vincent reviewed future therapeutic interventions that will likely involve multiple/combination therapies. Genomics and critical care, tissue factor and activated protein C, genetic analysis, latent mediators, and other problems, and the possibility of multiple or combination therapy are on the horizon. This last recommendation comes because factors to either block or stimulate individual mediators or anti-inflammatory agents have failed. The real question is how quickly these predictions will help our patients. The world of science and molecular biology is exciting but much of it is pure science and is not yet related to improved care in the intensive care unit (ICU) or operating room.


Septic Shock Severe Sepsis Acute Respiratory Distress Syndrome Septic Patient Chronic Granulomatous Disease 
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.


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© Springer-Verlag Italia 2003

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  • A. E. Baue

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