Integrative Biology and Genetic Variability: MODS’ Next Frontiers
Care of the critically ill patient has been revolutionized through advances in prehospital care, operative care, intensive care, and rehabilitative care. Systematic observation and dozens of rigorous clinical trials have yielded a complex picture of the patient in physiologic crisis who is at greatest risk for the multiple organ dysfunction syndrome (MODS). Widespread inflammation was suggested to be prerequisite to MODS, and a general hypothesis was articulated: that interruption of the biochemical cascade leading to this widespread inflammation would attenuate the progression and severity of MODS. More than two dozen clinical trials later, this simplistic hypothesis has been disproven. The purpose of this chapter is to explore the reasons why this apparently logical hypothesis concerning the pathogenesis of MODS might be incorrect and to consider alternative formulations of MODS pathogenesis.
KeywordsEntropy Rene Glean Haldane Timothy
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