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- W1994067722 abstract "Despite increasing sophistication in antimicrobial therapy and intensive care support of failing organs, mortality in critically ill patients with the adult respiratory distress syndrome (ARDS) and progressive multiple systems organ failure accompanying Gram-negative bacterial sepsis still exceeds 60 percent and shows no sign of decreasing, 15 Pohlman TH Stanness KA Beatty PG Ochs HD Harlan JM An endothelial cell surface factor(s) induced in vitro by lipopolysaceharide, interleukin 1, and tumor necrosis factor-alpha increases neutrophil adherence by a CDw18-dependent mechanism. J Immunol. 1986; 136: 4548-4553 PubMed Google Scholar However, the pathophysiologic conception of ARDS mediated by blood-borne factors has evolved significantly from a self-contained intrapulmonary process consisting of permeability edema, complicated by ensuing extrapulmonary organ system failures. At present, sepsis-induced ARDS may appropriately be viewed as the pulmonary expression of a pansystemic disorder. We propose that preexisting and acquired impairments of systemic host defenses lead to early generalized endothelial cell injury that simultaneously affects multiple organs. 6 Goris RJA te Boekhorst TPA Nuytinck JKS Gimbrere JSF Multiple-organ failure: generalized autodestructive inflammation?. Arch Surg. 1985; 120: 1109-1115 Crossref PubMed Scopus (1011) Google Scholar The resultant pulmonary dysfunction is manifest dramatically because changes in lung microvascular permeability lead to alveolar flooding, overt disturbances in gas exchange, and abnormal pulmonary mechanics. In contrast, early markers of extrapulmonary organ dysfunction are scarce because alterations in endothelial permeability are less functionally apparent. Ultimately, evolution of severely deranged host inflammatory responses owing to uncontrolled infection amplify tissue damage and lead to clinically overt dysfunction in all organs." @default.
- W1994067722 created "2016-06-24" @default.
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- W1994067722 date "1988-08-01" @default.
- W1994067722 modified "2023-10-13" @default.
- W1994067722 title "Organ Interactions in the Adult Respiratory Distress Syndrome during Sepsis" @default.
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- W1994067722 doi "https://doi.org/10.1378/chest.94.2.400" @default.
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