The law of the critical illness and its far-reaching implications

Abstract

Objective: The complexity of the relationship between multiple factors that are involved has hitherto prevented exploration of the exact mechanistic process which must be therapeutically modified to solve the longstanding problem constituted by high mortality due to extremely worsened outcomes of the critical illness. We therefore aimed to eliminate such hitherto unsurpassable difficulties with the method by which Albert Einstein approximated astronomical reality conceptually. Methods: We searched for the hypothesis that empirical findings suggest towards the nature of this mechanistic process and for an empirical statement that our law of the critical illness must satisfy if clinical reality is to be approximated conceptually by our description of the process.Results: We found that the mechanistic process to be therapeutically modified to reduce mortality due to extremely worsened outcomes of the critical illness is not that by which nucleated red blood cells (NRBC) appear in the circulation but rather that by which bad outcomes follow the failure of a hemoglobin-increasing mechanism of recovery even in those patients in whom NRBC positivity will not herald such outcomes. Conclusion: The understanding required to prevent death due to such outcomes is not that of a mechanism that reduces NRBC values but rather of one by which recovery may follow failure of this hemoglobin-increasing mechanism despite elevated values of these cells that predominate the blood of healthy birds or lower levels of hemoglobin whose absence in white-blooded icefish, similar to that of red blood cells, is not accompanied by bad outcomes that are attributed to anemias, hemoglobinopathies or thalassemias.