Multiple organ dysfunction syndrome: Exploring the paradigm of complex nonlinear systems
Multiple organ dysfunction syndrome: Exploring the paradigm of complex nonlinear systems
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DOI：
10.1097/00003246-200007000-00003
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发表时间：
2000-07-01
影响因子：
8.8
通讯作者：
Christou, NV
中科院分区：
文献类型：
--
作者：
Seely, AJE;Christou, NV
目的：本文的目的是介绍和探索一种基于复杂非线性系统的新范式，并评价其在重症监护中关于全身宿主反应和多器官功能障碍综合征（MODS）的研究中的应用。数据来源：已发表的原创作品、综述文章、科学摘要和书籍，以及我们的个人档案。选择研究是因为它们与非线性复杂系统的应用、重症监护医学以及所提出的概念相关。数据提取：我们提取了所有适用的数据。数据合成：在简要回顾MODS之后，介绍了复杂非线性系统，包括清晰的概念、定义和性质。通过研究代谢、神经、内分泌、免疫和炎症系统之间的多重、非线性、相互关联和可变的相互作用;关于相互关联的抗体网络的数据;以及炎症反应的冗余、非线性、相互依赖的性质，我们提出了这样的假设：全身性宿主对创伤、休克或脓毒症的反应必须作为一个复杂的非线性系统进行评估。该模型为使用各种抗介质疗法治疗脓毒症和MODS患者的试验失败提供了新的解释。了解主机响应作为一个复杂的非线性系统提供了创新的方法来研究重症监护患者，特别是通过建议更注重系统特性。我们假设个体变量的变异性和连通性的分析提供了一种新的方法来评估和区分一个复杂的非线性系统的系统特性。结论：复杂非线性系统的研究提供了新的思路，以追求研究，以评估，监测和治疗MOBS患者的范式。
Objectives: The objectives of this article are to introduce and explore a novel paradigm based on complex nonlinear systems, and to evaluate its application to critical care research regarding the systemic host response and multiple organ dysfunction syndrome (MODS).Data Sources: Published original work, review articles, scientific abstracts and books, as well as our personal files.Study Selection: Studies were selected for their relevance to the applications of nonlinear complex systems, to critical care medicine, and to the concepts presented.Data Extraction: We extracted all applicable data.Data Synthesis: Following a brief review of MODS, an introduction to complex nonlinear systems is presented, including clear concepts, definitions, and properties. By examining the multiple, nonlinear, interrelated, and variable interactions between the metabolic, neural, endocrine, immune, and inflammatory systems; data regarding interconnected antibody networks; and the redundant, nonlinear, interdependent nature of the inflammatory response, we present the hypothesis that the systemic host response to trauma, shock, or sepsis must be evaluated as a complex nonlinear system. This model provides a new explanation for the failure of trials using various antimediator therapies in the treatment of patients with sepsis and MODS. Understanding the host response as a complex nonlinear system offers innovative means of studying critical care patients, specifically by suggesting a greater focus on systemic properties. We hypothesize that analysis of variability and connectivity of individual variables offer a novel means of evaluating and differentiating the systemic properties of a complex nonlinear system. current applications of evaluating variability and connectivity are discussed, and insights regarding future research are offered.Conclusion: The paradigm offered by the study of complex nonlinear systems suggests new insights to pursue research to evaluate, monitor, and treat patients with MOBS.