TY - JOUR
TI - Correlating functional staging to effective treatment of acute surgical
illness
AU - Nomikos, LN
AU - Vamvakopoulos, NC
JO - AMERICAN JOURNAL OF SURGERY
PY - 2001
VL - 182
TODO - 3
SP - 278-286
PB - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
SN - 0002-9610
TODO - 10.1016/S0002-9610(01)00701-2
TODO - acute surgical illness; systemic inflammatory response syndrome;
multiple organ failure
TODO - Background: Proinflammatory and anti-inflammatory events may eventually
trigger host response, which acting via a broad spectrum of complex
biological processes and molecular interactions may either enhance or
resolve the symptoms of acute surgical illness (ASI). Staging the
sequence of biological events that take place at the cellular level
during the development of ASI may provide leads to effective
stage-specific treatments. In line with the hypothesis that proper
timing of therapeutic intervention may be crucial to the management of
the disease, we have attempted in this review to correlate functional
staging to effective treatment of ASI.
Data source: The present report proposes a conceptual synthesis on the
biogenesis and treatment of ASI that is based on known molecular and
cellular aspects of human inflammatory sequence and patient data from
clinical trials. It also introduces proper timing of therapeutic
intervention as a potentially important determinant for the successful
outcome of the disease process.
Conclusions: Progress in understanding the biogenesis of ASI did not
result in successful therapeutic developments as yet. The challenge
ahead should be a better understanding of the dynamics of the various
processes and regulators in appropriate animal and clinical models of
ASI, in order to properly intervene and direct effective therapies for
the benefit of critically ill patients. (C) 2001 Excerpta Medica, Inc.
All rights reserved.
ER -