To: aknahow who wrote (6826 ) 7/30/1998 7:35:00 AM From: Robert K. Respond to of 17367
The chinese seem to agree with the bacteria/translocation theory>>. >>this theory is the basis of the trauma & and other trials (IMO)<< >>also note the whos who are authoring these<< >>Redl (a -big hitter), Schlag (South african baboon study) Start>> >>The inflammatory basis of trauma/shock-associated multiple organ failure. Yao YM, Redl H, Bahrami S, Schlag G Trauma Research Center, 304th Hospital, Postgraduate Medical College, Beijing, China. [Medline record in process] Multiple alterations in inflammatory and immunologic function have been demonstrated in clinical and experimental situations after trauma and hemorrhage, in particular the activation of various humoral (e.g. complement, coagulation) and cellular systems (neutrophils, endothelial cells, macrophages). As a consequence of this activation process there is synthesis, expression and release of numerous mediators (toxic oxygen species, proteolytic enzymes, adherence molecules, cytokines), which may produce a generalized inflammation and tissue damage in the body. Mediators are responsible for ongoing interactions of different cell types and for amplification effects through their networks and feedback cycles, finally leading to a sustained inflammation and multiple organ damage in the body. In the setting of trauma/shock, many activators including bacterial as well as non-bacterial factors may be present that will induce local and systemic inflammatory responses. Although the potential role of bacteria/endotoxin translocation and its clinical relevance remains controversial, many lines of evidence support the concept that the gut may be the reservoir for systemic sepsis and subsequent MOF in a number of pathophysiologic states.