Posttraumatic Multiple Organ Failure—a Report on Clinical and Autopsy Findings

Pape, Hans-Christian; Remmers, D.; Kleemann, W. J.; Goris, J.A.; Regel, G.; Tscherne, H.

doi:10.1097/00024382-199409000-00012

Cited by 44 publications

(15 citation statements)

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“…As an example, trauma surgeons began to investigate the special care of single injuries [8,89] but especially interaction of these injuries and their systemic effects on the circulatory and immune system [24,68,69]. Therefore, interdisciplinary shock research groups have been created at several trauma centers, fostering interdisciplinary, joint efforts by trauma surgeons and basis scientists [25,57]. Two major research fields were addressed: (1) the clinical impact of surgical procedures on shock and on the development of multiorgan failure (MOF) and (2) studies on rehabilitation.…”

Section: Effects Of Clinical and Experimental Research On In-hospitalmentioning

confidence: 99%

Trauma Care in Germany: An Inclusive System

Sturm

Pape²,

Dienstknecht³

2013

Clinical Orthopaedics &Amp; Related Research

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Section: Effects Of Clinical and Experimental Research On In-hospitalmentioning

confidence: 99%

Trauma Care in Germany: An Inclusive System

Sturm

Pape²,

Dienstknecht³

2013

Clinical Orthopaedics &Amp; Related Research

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“…The progressive endothelial dysfunction leads to increased microvascular permeability with transudation into the organs [16][17][18]. In addition, microthrombi develop that obstruct the microcirculation with subsequent local ischemia [19,20].…”

Section: Exacerbating Systemic Inflammationmentioning

confidence: 99%

Immune Reactions after Trauma

2003

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Activation of the immune system for wound healing following accidental trauma is a well-studied phenomenon. The reaction comprises both the cellular and humoral systems. The various steps in the reaction are all temporally defined and influence each other. The main cells involved are polymorphonuclear granulocytes (PMN), monocytes, and lymphocytes. They interact and adhere to the endothelium via adhesion molecules such as L-selectin and ICAM-1. The humoral mediators discussed in this review are tumor necrosis factor-␣ (TNF-␣) and its receptors, interleukin-1␤ (IL-1␤), IL-6, IL-10 and interferon-␥ (IFN-␥). The kinetics of the cells appearing and of the cytokines are discussed. The actions of these players are reviewed along with the most recent literature. Furthermore, we attempt to elucidate causal relationships. The immune system can be hyper-or hypoactive. Both exaggerated pro-and antiinflammatory reactions may have the same endpoint: multiple organ dysfunction syndrome (MODS). This knowledge should be used to meticulously monitor the patient's immunologic status. Depending on the state, hyper-or hypoinflammatory, the treatment should comprise anti-inflammatory and immune-restoring properties, respectively. What is decisive to survival is timely, adequate management based on the individual patient's status.

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“…In einer Anwendungsbeobachtung bei polytraumatisierten Patienten mit schwerem Thoraxtrauma sollten eigene Erfahrungen gesammelt und Wirkung sowie Nebenwirkung geprüft werden. sache der schlechteren Prognose ist das posttraumatische Lungenversagen [20,22,30] mit den indirekten Folgen der Gewebehypoxie und schließlich dem klassischen Bild des ARDS. Dominiert wird das pulmonale Versagen durch die Ventilationsstörung der primär und sekundär geschädigten Lungenareale.…”

Section: Ei N Begleitendes Thoraxtrauma Erhöht Bei Polytraumatisiertenunclassified