Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction.
Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction.
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20世纪90年代的多器官衰竭综合症。
DOI：
10.1001/jama.1994.03510270072043
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
F. Cerra
中科院分区：
文献类型：
--
作者：
A. Beal;F. Cerra
目的：本综述对全身炎症反应综合征（SIRS）和多器官功能障碍综合征（MODS）进行了概述，这是危重患者常见但复杂的问题。它强调定义，常见的临床模式，代谢反应和病理生理变化。还包括治疗概念的简要讨论。资料来源--本综述的资料来自同行评议的期刊、SIRS/MODS专家的综述文章以及从SIRS/MODS参考书中选取的资料。研究选择-参考选择的基础上，研究的质量。同行评审的期刊是首要考虑的。人们认为引用的这些评论文章对于SIRS/MODS的任何讨论都至关重要。资料提取--在可能的情况下，随机对照前瞻性研究被回顾，结论被用于SIRS/MODS的综述。结论--我们对危重病人的护理能力已经导致了一个新的问题，SIRS和最终的MODS，可能发展为进行性器官衰竭和死亡。不幸的是，这些情况非常频繁，死亡率很高。增加的耗氧量需求突出了生理反应。典型的代谢反应以高血糖和加速的蛋白质分解为特征。无法识别的灌注缺陷、不受控制的脓毒症病灶、持续性炎症源或损伤的组织通常存在于SIRS/MODS中，应予以纠正。恢复氧运输和代谢支持也是治疗的重要组成部分。SIRS/MODS的原因是复杂的，尚未完全了解，但多种介质和刺激的巨噬细胞可能是治疗的重要组成部分和领域。
OBJECTIVE--This review of the systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) provides an overview of a common but complex problem found in critically ill patients. It emphasizes definitions, common clinical patterns, metabolic responses, and pathophysiological changes. A brief discussion of treatment concepts is also included. DATA SOURCES--Data for this review were gathered from peer-reviewed journals, review articles by experts in SIRS/MODS, and selections from reference volumes written on SIRS/MODS. STUDY SELECTION--Reference selections were chosen on the basis of quality of research. Peer-reviewed journals were given primary consideration. Those review articles cited were felt to be essential to any discussion of SIRS/MODS. DATA EXTRACTION--Where possible, randomized, controlled, prospective studies were reviewed and conclusions used in this overview of SIRS/MODS. CONCLUSION--Our ability to care for critically ill patients has led to a new problem, SIRS and eventually MODS, which may become progressive organ failure and death. Unfortunately, these conditions are extremely frequent and carry high mortality rates. Increased oxygen consumption demands highlight the physiological response. The typical metabolic responses are characterized by hyperglycemia and accelerated protein catabolism. Unrecognized perfusion deficits, an uncontrolled septic focus, a persistent source of inflammation, or injured tissue is commonly present with SIRS/MODS and should be corrected. Restoration of oxygen transport and metabolic support are also important components of treatment. The cause of SIRS/MODS is complex and not fully understood, but multiple mediators and stimulated macrophages likely are important components and areas where treatment may well be focused.
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影响因子：
20.3
作者：
C. Dinarello
通讯作者：
C. Dinarello
影响因子：
3.8
作者：
J. Daly;Lieberman;J. Goldfine;J. Shou;F. Weintraub;Rosato Ef;P. Lavin
通讯作者：
J. Daly;Lieberman;J. Goldfine;J. Shou;F. Weintraub;Rosato Ef;P. Lavin
影响因子：
9
作者：
OCHOA, JB;UDEKWU, AO;PEITZMAN, AB
通讯作者：
PEITZMAN, AB
多器官衰竭期间细胞氧的利用。
影响因子：
4.3
作者：
Gutierrez,G;Lund,N;Bryan-Brown,CW
通讯作者：
Bryan-Brown,CW
抑制环加氧酶可减弱人体对内毒素的代谢反应。
DOI：
10.1001/archsurg.1988.01400260042004
发表时间：
1988
期刊：
Archives of surgery (Chicago, Ill. : 1960)
影响因子：
--
作者：
Revhaug,A;Michie,HR;Manson,JM;Watters,JM;Dinarello,CA;Wolff,SM;Wilmore,DW
通讯作者：
Wilmore,DW