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.
KeywordsHeart Rate Variability Multiple Organ Dysfunction Syndrome Infinite Impulse Response Infinite Impulse Response Filter15 Integrative Biology
Unable to display preview. Download preview PDF.
- 1.Descartes R: Rules for the Direction of the Mind, Rule IXGoogle Scholar
- 2.Bernard C: Leçons sur les Phènoménes de la Vie Communs aux Animaux et aux Végétaux. Paris, Ballière, 1878. This translation is in Fulton JF: Selected Readings in the History of Physiology. New York, Charles C Thomas, 1930; 307.Google Scholar
- 7.Kauffman SA: The Origins of Order: Self-organization and Selection in Evolution. New York, Oxford University Press, 1993; 173–235.Google Scholar
- 13.Glass L, Mackey MC: From Clocks to Chaos: The Rhythms of Life. Princeton, Princeton University Press, 1988; 136.Google Scholar
- 14.Schafer C, Rosenblum MG, Abel H-H, Kurths J: Synchronization in human cardiorespiratory system. Phys Rev 1999 (in press)Google Scholar
- 15.Hahn SL: Hilbert Transforms in Signal Processing. Boston, Artech House, 1996; 226.Google Scholar
- 19.Goldstein B, Buchman TG: Heart rate variability in intensive care. J Intensive Care Med 1998; 13: 252–265.Google Scholar