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Considerations in Organ Failure

  • Carlos Ortiz-LeybaEmail author
Chapter

Abstract

Recent advances about multiple-organ failure have highlighted several aspects of its diagnosis and management. However, broad areas remain undiscovered. The classic differentiation into two hits has been challenged with the discovery of mixed gene responses and prolonged clinical outcomes, leading to a new proposed concept, the persistent inflammation-immunosuppression catabolism syndrome (PICS). The incidence ranges between 15 and 40 % and associated mortality is six- to eightfold higher than patients without organ dysfunction. Current scoring systems are valid but are not useful for prognosis, as all of them lack specificity and sensibility for selected populations. Single organ dysfunction criteria has been revisited and revised: Berlin ARDS criteria, AKIN classification, and gastrointestinal failure. Physiopathology research has specially focused on gene involvement, neural regulation, and mitochondrial damage as future targets for innovative therapies. A search for early biomarkers is underway with limited results, and traditional nutritional support guidelines have been challenged.

Keywords

Acute Lung Injury Acute Respiratory Distress Syndrome Migration Inhibitory Factor Sequential Organ Failure Assessment Disseminate Intravascular Coagulation 
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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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Head of the Department of Internal Medicine and Critical Care UnitHospital Quirón Sagrado CorazónSevillaSpain

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