Shock, Sepsis, and Organ Failure

The First Wiggers Bernard Conference on Shock, Sepsis and Organ Failure, named after two outstanding scientists in shock research and experimental medicine, took an interdisciplinary approach, in hopes of gaining new perspective in understanding the development of the multi-organ failure. This book updates basic and clinical information on the state-of-the-art of the pathophysiology of multi-organ failure. Both clinicians and scientists concerned with basic research will find it to be a valuable source.

Carl J. Wiggers.- Claude Bernard.- 1. What is Multi-Organ-Failure - Is it a Sequence of Organ Failures or a Systemic Disease?.- Clinical Manifestations and Sequences of Organ Failure.- Discussion.- The Specific Role of ARDS in the Development of Multiple Organ Failure.- Discussion.- Quantification of Organ Failure.- Discussion.- The Metabolic Basis of the Septic Multiple Organ Failure Syndrome: Abnormal Energetic Fuel Control, Pathophysiologic Proteolysis and Futile Cycling of Hepatically Synthesized Substrates.- Discussion.- Humoral and Cellular Activation in Blood Leading to Organ Failure.- Discussion.- Endothelium as the Interface Between Blood and Organ in the Evolution of Organ Failure.- Discussion.- Cellular Metabolic Responses in Endotoxemia, and a Hypothesis for the Mechanism of Hepatic Failure in Endotoxic Shock.- Discussion.- 2. Cellular Events in Trauma and Sepsis - Suppression Versus Activation or Both ?.- Posttraumatic Immune Suppression as Initiator of Organ Failure.- Humoral Factors in Immune Suppression After Injury.- Discussion.- Activation of Neutrophils and the Role of Eicosanoids in the Initiation of Organ Failure.- Discussion.- Role of Xanthine Oxidase-Derived Oxidants and Granulocytes in Ischemia/Reperfusion.- Discussion.- Role of Proteinases in the Pathophysiology of Organ Failure.- Discussion.- Activation of Cellular Membrane Receptors; Intracellular Messengers and Mediators of the Response to Injury.- Discussion.- 3. Mediators of Organ Failure - Are LPS or Sepsis Necessary ?.- Experimental Induction of Whole Body Inflammation Leads to ARDS, Multiple Organ Failure and Sepsis. The ZIGI-Model in Rats and Mice.- Discussion.- Endotoxin-Initiated Organ Failure Responses.- Discussion.- Through a Glass Darkly: The Gut in Multiple Organ Failure.- Discussion.- Changes in Mesenteric Blood Flow Affects Translocation in Sheep.- Discussion.- Antagonists of Platelet-Activating Factor as Potential Therapeutic Agents in Shock.- IL-1 and TNF: Mediators of LPS-Induced Neutrophil Emigration and Thrombosis.- Discussion.- 4. Conference Summary and Concluding Remarks.- Multiple Organ Failure as a Systemic Disease of Host-Defense Failure.- Final Discussion.