Mechanisms of Organ Dysfunction in Critical Illness

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Timothy W. Evans, Mitchell P. Fink
Springer Science & Business Media, Jan 21, 2002 - Medical - 410 pages
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The pathophysiology of sepsis can be regarded as a series of steps, beginning with the invasion of normally sterile tissue by microbes and the elaboration of various pro-inflammatory mediators. The final common pathway is often the development of the multiple organ dysfunction syndrome (MODS). Whereas a great deal has been learned during the past quarter century about the inflammatory processes associated with sepsis (and other related conditions, such as ischemia/reperfusion injury), our understanding is far less developed with respect to the pathophysiological events that lead to organ dysfunction under these conditions. Nevertheless, efforts by both clinical and laboratory scientists are leading to new knowledge in this area. The chapters in this volume provide a state-of-the-art overview of many aspects of the pathophysiology of organ dysfunction in critical illness.
 

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Contents

Role of Oxidant Signal Transduction
3
A Pore Way to Die
17
The Role of Poly ADPRibose Synthetase Activation
40
Derangements in Cellular Oxygen Metabolism
52
Pharmacologic and Metabolic Mitochondrial Rescue
69
Leukocytes and Cell Signaling Mechanisms in Inflammation
93
Role of Leukocytes in Sepsis and Lung Injury
95
Dysregulated Neutrophil Apoptosis in the Pathogenesis of Organ Injury in Critical Illness
110
Mechanisms and Functional Significance
227
Multiple Organ Failure and the Kidney
239
Apoptosis in Renal Ischemia Reperfusion Injury
253
Gastrointestinal Tract
265
Local Muscularis Inflammatory Mechanisms of Ileus
267
Mechanisms Responsible for Intestinal Barrier Dysfunction in Critical Illness
282
Nitric Oxide Carbon Monoxide and Reactive Oxygen Species
301
Brain Injury
313

Does Apoptosis Play a Role in the Development of SepsisInduced Myocardial Dysfunction?
124
The Intracellular Signaling Pathways of Inflammatory Stress
137
DoubleEdged Swords in the Pathogenesis of Bacterial Infection
146
OrganOrgan Interactions in Multiple Organ Failure
159
Microcirculatory Dysfunction
173
Endothelial Cell Dysfunction and Abnormal Tissue Perfusion
175
The Microcirculation in Sepsis
191
Lung and Kidney
203
Pulmonary Vascular Dysfunction
205
Clinical and Experimental Evidence for a Major Role in Acute Lung Injury and Multiple Organ Dysfunction
222
Polyamine Oxidase and 3Aminopropanal in the Pathogenesis of Cerebral Ischemia
315
Key Mechanisms of Secondary Neuronal Damage After Brain Trauma
327
Pathophysiology and Neuroprotection
339
Detection and Intervention
349
Redistribution of Microvascular Oxygen Pressures in the Pig Intestine in Hemodilution and Sepsis
351
Influence of Mechanical Ventilation on Organ Dysfunction
363
Coagulation Abnormalities in Critical Illness
376
Clinical Syndrome
394
Subject Index
405
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Page 373 - Acute Respiratory Distress Syndrome Network: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.
Page 402 - Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.
Page 401 - Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 1994:330:1717-22.
Page 401 - Bernard GR, Vincent JL, Laterre PF, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis.
Page 401 - Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients.
Page 373 - High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure.

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