Presidential Address: Imagination trumps knowledge
Abstract Multiple organ failure (MOF) emerged 30 years ago and became our research focus. Over the years, we have proposed a series of cartoons that rallied multidisciplinary translational research teams around common themes to generate “win-win” hypotheses that when tested (right or wrong) have adv...
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Published in | The American journal of surgery Vol. 200; no. 6; pp. 671 - 677 |
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Main Author | |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.12.2010
Elsevier Limited |
Subjects | |
Online Access | Get full text |
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Summary: | Abstract Multiple organ failure (MOF) emerged 30 years ago and became our research focus. Over the years, we have proposed a series of cartoons that rallied multidisciplinary translational research teams around common themes to generate “win-win” hypotheses that when tested (right or wrong) have advanced our understanding of MOF. MOF has a bimodal trajectory, and the gut plays a role in both trajectories. Early MOF occurs because of excessive proinflammation (ie, systemic inflammatory response syndrome [SIRS]), and early gut ischemia-reperfusion can amplify SIRS and contribute to the early fulminant SIRS-MOF trajectory. Fortunately, most patients survive early SIRS, but some develop excessive anti-inflammation (ie, compensatory anti-inflammatory response syndrome). The gut also plays a role in this late indolent compensatory anti-inflammatory response syndrome–MOF trajectory. Multiple factors cause progressive gut dysfunction such that the gut (an important immunologic organ) worsens compensatory anti-inflammatory response syndrome and becomes the reservoir for pathogens and toxins that cause late sepsis. |
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Bibliography: | SourceType-Other Sources-1 ObjectType-Article-1 content type line 63 ObjectType-Undefined-2 |
ISSN: | 0002-9610 1879-1883 |
DOI: | 10.1016/j.amjsurg.2010.05.009 |