The Syndromes of Systemic Inflammatory Response and Multiple Organ Dysfunction

INTRODUCTION EPIDEMIOLOGY The Civilian Experience The Military Experience Traumatic Injury Trauma-Related Sepsis and Septic Shock Cellular and Subcellular Mechanisms Leading to SIRS/MODS Components and Products From Microorganisms Giving Rise to SIRS/MODS Cellular Components Contributing to SIRS/MODS Endogenous Mediators ORGAN-SPECIFIC RESPONSES Cardiovascular Response Pulmonary Response Renal Dysfunction Neurological Manifestations Metabolic and Endocrinological Responses Immunological Aberrations Surgery in the Immunocompromised Patient With Sepsis/SIRS Hematological and Coagulation Defects Dermatological and Ophthalmological Manifestations DIAGNOSIS AND MONITORING Hematological Evaluation Microbiologic Evaluation Sophisticated Bedside Monitors Radiological Procedures Surgical Reexploration THERAPEUTIC MODALITIES Fluid Resuscitation Selection of Resuscitation Fluid Tissue Oxygen Delivery and Consumption Inotropic and Vasopressor Drugs Support of the Respiratory System Antimicrobial Therapy Proposed Therapies Immunotherapy Corticosteroids Naloxone Cyclooxygenase Inhibitors Metabolic Manipulations ESTABLISHED MULTIPLE ORGAN FAILURE Prevalence Prognosis Etiology and Pathophysiology Clinical Manifestations Current Treatment Modalities