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The Multiple Organ or System Failure Syndrome

  • Chapter
Pathophysiology of Shock, Sepsis, and Organ Failure

Abstract

Throughout the short history of modern surgery — whether one begins with Ambrose Pare, John Hunter, or Theodor Billroth — there have been limits to surgical capability. Whether these limits were imposed by pain, requiring the development of anesthesia; hemorrhage and fluid loss, requiring hemostasis and intravenous fluids; or infection, requiring antisepsis, asepsis, and antibiotics, there have always been challenges to develop technical resources and biologic understanding beyond our existing capability. This striving by the surgical practitioner, academician, or investigator to extend the limits of surgery is part, not only of our heritage, but of our responsibility to our patients and the profession. Certainly, there are limits in the treatment of certain types of diseases. There are limits to what we can accomplish by extirpation of cancer and bypass grafts for atherosclerotic occlusions, as prime examples. There are limits or weak links also in our overall capability to care for patients after severe injury, after major life-threatening operations, with catastrophic illnesses requiring operations for treatment, and in patients with significant chronic illness who face many of these problems.

“A chain is only as strong as its weakest link. When links are strengthened where the chain has broken previously, new weak spots appear simply because the chain holds to test them. The obvious weak link in the severely wounded in this war [WW II] was the kidney.”

Edward D. Churchill [1]

“What then is the next limiting organ system after severe, overwhelming trauma, either in the field or in the operating room? It seems that the major limiting factor after injury — is not so much a system, but rather a combination of events that can best be called multiple systems failure.”

Arthur E. Baue [2]

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Author information

Authors and Affiliations

  1. Department of Surgery, Cardiothoracic Division, Saint Louis University School of Medicine, 3635 Vista, P.O. Box 15250, St. Louis, MO, 63110-0250, USA

    A. E. Baue (Professor of Surgery)

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  1. A. E. Baue
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Editor information

Editors and Affiliations

  1. Ludwig-Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstraße 13, A-1200, Vienna, Austria

    Günther Schlag M. D.  & Heinz Redl Ph. D.  & 

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© 1993 Springer-Verlag Berlin Heidelberg

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Baue, A.E. (1993). The Multiple Organ or System Failure Syndrome. In: Schlag, G., Redl, H. (eds) Pathophysiology of Shock, Sepsis, and Organ Failure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76736-4_68

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  • DOI: https://doi.org/10.1007/978-3-642-76736-4_68

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-76738-8

  • Online ISBN: 978-3-642-76736-4

  • eBook Packages: Springer Book Archive

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