Mechanisms of Organ Dysfunction in Critical Illness

by Timothy W. Evans (Editor), Mitchell P. Fink (Editor)

Overview

The pathophysiology of sepsis can be regarded as a series of steps, beginning with the invasion of normally sterile tissue by microbes and the elaboration of various pro-inflammatory mediators. The final common pathway is often the development of the multiple organ dysfunction syndrome (MODS). Whereas a great deal has been learned during the past quarter century about the inflammatory processes associated with sepsis (and other related conditions, such as ischemia/reperfusion injury), our understanding is far less developed with respect to the pathophysiological events that lead to organ dysfunction under these conditions. Nevertheless, efforts by both clinical and laboratory scientists are leading to new knowledge in this area. The chapters in this volume provide a state-of-the-art overview of many aspects of the pathophysiology of organ dysfunction in critical illness.

Product Details

ISBN-13:	9783642561078
Publisher:	Springer-Verlag New York, LLC
Publication date:	12/06/2012
Series:	Update in Intensive Care Medicine
Sold by:	Barnes & Noble
Format:	eBook
File size:	9 MB

About the Author

Evans, Timothy W.; Fink, Mitchell P.

Table of Contents

Mitochondrial Biology.- Cellular Responses to Hypoxia: Role of Oxidant Signal Transduction.- The Mitochondrial Permeability Transition: A ‘Pore ‘Way to Die.- Cytopathic Hypoxia in Circulatory Shock: The Role of Poly (ADP-Ribose) Synthetase Activation.- Derangements in Cellular Oxygen Metabolism.- Pharmacologic and Metabolic Mitochondrial Rescue.- Leukocytes and Cell Signaling Mechanisms in Inflammation.- Role of Leukocytes in Sepsis and Lung Injury.- Dysregulated Neutrophil Apoptosis in the Pathogenesis of Organ Injury in Critical Illness.- Does Apoptosis Play a Role in the Development of Sepsis-Induced Myocardial Dysfunction?.- The Intracellular Signaling Pathways of Inflammatory Stress.- Pro-Inflammatory Cytokines: Double-Edged Swords in the Pathogenesis of Bacterial Infection.- Organ-Organ Interactions in Multiple Organ Failure.- Microcirculatory Dysfunction.- Endothelial Cell Dysfunction and Abnormal Tissue Perfusion.- The Microcirculation in Sepsis.- Lung and Kidney.- Pulmonary Vascular Dysfunction.- Pulmonary Epithelial Injury: Clinical and Experimental Evidence for a Major Role in Acute Lung Injury and Multiple Organ Dysfunction.- Ischemia-Induced Derangements in the Actin Cytoskeleton: Mechanisms and Functional Significance.- Multiple Organ Failure and the Kidney.- Apoptosis in Renal Ischemia-Reperfusion Injury.- Gastrointestinal Tract.- Local Muscularis Inflammatory Mechanisms of Ileus.- Mechanisms Responsible for Intestinal Barrier Dysfunction in Critical Illness.- Liver Dysfunction: Nitric Oxide, Carbon Monoxide, and Reactive Oxygen Species.- Brain Injury.- Polyamine Oxidase and 3-Aminopropanal in the Pathogenesis of Cerebral Ischemia.- Key Mechanisms of Secondary Neuronal Damage After Brain Trauma.- Cerebral Ischemia: Pathophysiology andNeuroprotection.- Organ Dysfunction: Detection and Intervention.- Redistribution of Microvascular Oxygen Pressures in the Pig Intestine in Hemodilution and Sepsis.- Influence of Mechanical Ventilation on Organ Dysfunction.- Coagulation Abnormalities in Critical Illness.- Multiple Organ Failure: Clinical Syndrome.

Editorial Reviews

3 Stars from Doody

Reviewer: David James Dries, MSE, MD (Regions Hospital)
Description: This monograph, volume 38 in the Update in Intensive Care and Emergency Medicine series, describes cellular and molecular dysfunction of organs in the intensive care unit. Organ crosstalk is also discussed.
Purpose: Provided is a description of multiple organ failure which steps beyond traditional epidemiologic and organ support strategies. More contemporary concerns including apoptosis, oxidant injury, mitochondrial dysfunction, and the contribution of mechanical ventilation to organ failure are discussed.
Audience: Practitioners and senior trainees in critical care medicine are an appropriate audience for this book. Authors are senior investigators from Western Europe and North America.
Features: Content is divided topically, but not by the traditional organ systems. For example, leukocytes and cell signaling are discussed in one portion of the book while mitochondrial biology and microcirculation are discussed elsewhere. Traditional, organ-specific discussion is also provided for major organs in the multiple organ failure cascade including the brain, lung, kidney, and gastrointestinal tract. The 28 chapters are concise and well written. Texture of type divides major subheadings. Black-and-white line drawings are occasionally included and these reproduce well. Chapters have ample reference lists with citations of original work dating to within two years of the publication. The table of contents divides chapters according to major topic and provides authorship. The subject index provides adequate access to the content of this work, but lacks specific citations for tables or figures.
Assessment: This book can be recommended for an enticing reorganization of information traditionally associated with this field. Here the reader will find multiorgan dysfunction discussed from cellular, molecular, isolated organ, and organ interaction perspectives. Although there is some chapter overlap as is common in multiauthor texts, the organization of this book allows adequate access to new developments in this area.

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