EVOLVING CONCEPTS IN THE PATHOGENESIS OF POSTINJURY MULTIPLE ORGAN FAILURE

Multiple organ failure (MOF) occurs as a result of unbridled systemic inflammatory response syndrome (SIRS). Early epidemiologic studies identified uncontrolled late infection as the pre-dominant mechanism and, consequently, research efforts were focused on ''infectious models.'' Recently, it has been recognized that SIRS and eventually MOF can occur in the absence of infection and that late infections may simply represent symptoms of MOF. Thus, newer ''inflammatory models'' have been proposed with a consequent shift in research interest to determine how initial traumatic insults establish SIRS, independent of infection that is conducive for the development of MOF.