Multiple organ failure. How valid is the "two hit" model?

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Multiple organ failure. How valid is the "two hit" model?

Inflammatory "one hit" and "two hit" models have recently been proposed to account for the development of multiple organ failure (MOF) in trauma and critically ill surgical patients when no source of infection can be found. In the "one hit" model, the initial insult is so massive that a systemic inflammatory response syndrome is triggered and leads rapidly to MOF. In the "two hit" scenario, ini...

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Two-hit hypothesis and multiple organ dysfunction syndrome.

A severe insult in the form of infection or trauma primes the host immune system so that a subsequent, relatively trivial insult produces a markedly exaggerated host immune response, which can lead to multiple organ dysfunction syndrome (MODS) and death. This forms the basis of the "two-hit hypothesis" (THH), which is being increasingly recognised as an important cause of morbidity and mortalit...

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The Splanchnic Model of Multiple Organ Failure

Ischemia signifies failure to satisfy the metabolic needs of the cell secondary to either impaired oxygen delivery or the impairment of cellular oxygen extraction and utilization. Incomplete splanchnic cellular resuscitation has been associated with the development of multiple organ system failure and increased mortality in the critically ill patient (1,2). For many years, the merits of augment...

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Evaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia

BACKGROUND Novel extracorporeal procedures are constantly being developed and evaluated for use in patients with sepsis. Preclinical evaluation of such procedures usually requires testing in large animal models. In the present work, the safety and efficacy of a recently developed ADVanced Organ Support (ADVOS) system in a newly developed large animal two-hit model of liver failure combined with...

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Multiple organ dysfunction during resuscitation is not postinjury multiple organ failure.

HYPOTHESIS Multiple organ dysfunction (MOD) within 48 hours of injury is a reversible physiologic response to tissue injury and resuscitation. DESIGN A prospective 10-year inception cohort study ending September 2003. SETTING Regional academic level I trauma center. PATIENTS One thousand two hundred seventy-seven consecutive trauma patients at risk for postinjury multiple organ failure (M...

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ژورنال

عنوان ژورنال: Emergency Medicine Journal

سال: 1999

ISSN: 1472-0205,1472-0213

DOI: 10.1136/emj.16.3.163