Pathophysiology of Shock, Sepsis, and Organ Failure

Introduction: “Organ in Shock”, “Early Organ Failure”, “Late Organ Failure”.- Trauma, Shock and Development of the Organ in Shock and Early Organ Failure (SIRS).- Shock, Sepsis, and Multiple Organ Failure: The Result of Whole-Body Inflammation.- The Role of Complement.- Activation of Humoral Systems. The Role of Coagulation, Fibrinolysis, and the Plasma Kallikrein-Kinin System.- Proteinases.- Cellular Mechanisms of Leukocyte Adhesion.- Eicosanoids in Trauma and Traumatic Shock.- Radical Related Cell Injury.- Humoral Mechanisms.- Monocyte and Lymphocyte Responses Following Trauma.- Metabolic Response to Trauma.- Morphology of the Lung as a Consequence of Direct and Indirect Trauma.- Permeability Changes.- Cardiac Function During Hypovolemia.- Cardiodepressant Factors.- Response of the Macrocirculation.- Response of the Microcirculation: Tissue Oxygenation.- Cardiovascular Function in Acute Burns.- Morphology of the Liver in Shock.- Bacterial Translocation.- Bacterial Translocation During Traumatic Shock in Baboons.- Bacterial Translocation in Polytrauma Patients.- Bacterial Translocation in Burns.- Hypoxic Damage.- Reperfusion Injury in the Small Intestine.- Kidney Blood Flow Changes in Shock.- Central Nervous System Response to Trauma.- Rat and Mouse Models of Hypovolemic-Traumatic Shock.- Hypovolemic-Traumatic Shock Models in Baboons.- The Development of the Sepsis and Multi-Organ-Dysfunction-Syndrome (MODS).- The Active Principle of Bacterial Lipopolysaccharides (Endotoxins) for Cytokine Induction.- LPS Plasma Levels in Patients.- Bacterial Exotoxins and Vascular Injury.- Complement in Sepsis.- Activation of Humoral Systems: Coagulation, Fibrinolysis, and Plasma Kallikrein-Kinin Systems.- The Cytokine Network in Trauma and Sepsis I: TNF and IL-8.- The Cytokine Network in Sepsis II: IL-1 and IL-6.- Platelet-Activating Factor in Shock, Sepsis, and Organ Failure.- Endotoxin Activation of Eicosanoid Production by Macrophages.- Proteolytic Enzyme Systems.- Activation/Adherence Phenomena of Leukocytes and Endothelial Cells in Trauma and Sepsis.- Procoagulant Response of the Endothelium and Monocytes.- The Role of the L-Arginine Nitric Oxide Pathway in Sepsis and Endotoxaemia with Special Reference to Vascular Impairment.- Cytokine Modulation of Glucose Metabolism.- Mechanism of Insulin Resistance in Infection.- The Host Defense to Trauma and Sepsis: Multiple Organ Failure as a Manifestation of Host Defense Failure Disease.- Experimentally Induced DIC — DIC as a Cause of MOF.- Three Clinical Presentations of E. coli Sepsis as Studied in the Baboon Model.- Morphology of the Lung in Late Septic Shock.- Morphological Changes in Adult Respiratory Distress Syndrome: Experimental and Clinical Data.- The Role of Respiratory Failure in Multiorgan Failure.- Fibronectin and the Reticuloendothelial System: Relationship to Lung Vascular Failure During Septic Shock.- Abnormalities of the Lung Surfactant System in Acute Lung Injury.- Experimental Models in Surfactant Research.- Myocardial Dysfunction in Experimental Shock.- “Negative Inotropic Cascades” in Cardiomyocytes Triggered by Substances Relevant to Sepsis.- Myocardial Dysfunction in Experimental Septic Shock.- Pathomorphological Aspects of the Heart in Septic Patients.- Clinical Manifestations of Cardiovascular Dysfunction in Sepsis.- Coronary Hemodynamics and Myocardial Metabolism in Sepsis and Septic Shock.- Peripheral Macro- and Microcirculation.- Relationship Between Oxygen Demand and Oxygen Supply in Severe Sepsis.- Hepatic Responses to Bacterial Endotoxin (LPS).- Experimental Liver Failure.- Hepatic Dysfunction in Shock and Organ Failure.- Sepsis Related Renal Morphological Alterations and the Functional Correlates.- The Kidney in Sepsis.- Neurologic Abnormalities in Sepsis.- The Multiple Organ or System Failure Syndrome.- Models of Endotoxemia in Rodents.- Models of Endotoxemia in Sheep.- Rodent Models of Endotoxemia and Sepsis.- Sheep and Pigs as Animal Models of Bacteremia.- Live Escherichia coli Sepsis Models in Baboons.- Animal Models of Endotoxemia and Sepsis.- Models of Sepsis: Subacute Peritonitis in Sheep and Rats.- Chronic Models of Endotoxemia and Sepsis: Lessons from Both a Canine Peritonitis and a Human Endotoxemia Model.