Nonlinear dynamics, complex systems, and the pathobiology of critical illness.
Nonlinear dynamics, complex systems, and the pathobiology of critical illness.
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DOI：
10.1097/01.ccx.0000139369.65817.b6
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发表时间：
2004-10-01
影响因子：
3.3
通讯作者：
Buchman, Timothy G
中科院分区：
文献类型：
--
作者：
Buchman, Timothy G
综述目的：本综述在复杂系统科学的背景下探讨危重病和重症监护中的问题。正常生理学具有非线性动力学特征，而危重病的病理生理学似乎改变了这些动力学。
近期发现：近期证据证实并拓展了这样的观察结果，即正常生理学所具有的丰富变异性在危重病时会“去复杂化”。动物以及现在人类的实验数据表明，模拟正常变异性的生理支持可能会降低疾病的严重程度和/或持续时间。
总结：健康和危重病时的生理动力学似乎反映了复杂的、相互关联的系统生物学。疾病过程中和恢复期间的变化可能为系统的潜在结构提供重要线索。有了对结构的了解，治疗可以更好地侧重于支持功能和动力学，为改善预后带来希望。
PURPOSE OF REVIEW: The review considers problems in critical illness and critical care in the context of complex systems science. Normal physiology is characterized by nonlinear dynamics, and it appears that the pathophysiology of critical illness alters those dynamics.RECENT FINDINGS: Recent evidence confirms and extends the observation that the rich variability that characterizes normal physiology "decomplexifies" with critical illness. Experimental data in animals and now in humans suggests that physiologic support that mimics normal variability may reduce the severity and/or duration of the illness.SUMMARY: Physiologic dynamics in health and in critical illness appear to reflect complex, interconnected systems biology. Alterations in illness and during recovery may provide important clues to the underlying structure of the system. With knowledge of the structure, therapy could be better focused toward supporting both function and dynamics, offering hope for improved outcomes.