Sauaia Angela, Moore Frederick A, Moore Ernest E
University of Colorado Denver, 655 Broadway #365, Denver, CO 80203, USA.
University of Florida, PO BOX 100108, Gainesville, FL 32610, USA.
Crit Care Clin. 2017 Jan;33(1):167-191. doi: 10.1016/j.ccc.2016.08.006.
The development of organ dysfunction (OD) is related to the intensity and balance between trauma-induced simultaneous, opposite inflammatory responses. Early proinflammation via innate immune system activation may cause early OD, whereas antiinflammation, via inhibition of the adaptive immune system and apoptosis, may induce immunoparalysis, impaired healing, infections, and late OD. Patients discharged with low-level OD may develop the persistent inflammation-immunosuppression catabolism syndrome. Although the incidence of multiple organ failure has decreased over time, it remains morbid, lethal, and resource intensive. However, single OD, especially acute lung injury, remains frequent. Treatment is limited, and prevention remains the mainstay strategy.
器官功能障碍（OD）的发展与创伤诱导的同时发生的、相反的炎症反应之间的强度和平衡有关。通过先天免疫系统激活引发的早期炎症可能导致早期OD，而通过抑制适应性免疫系统和细胞凋亡产生的抗炎作用可能诱发免疫麻痹、愈合受损、感染和晚期OD。伴有轻度OD出院的患者可能会发展为持续性炎症-免疫抑制-分解代谢综合征。尽管多器官功能衰竭的发生率随着时间的推移有所下降，但它仍然具有高致病性、致死性且资源消耗巨大。然而，单一器官功能障碍，尤其是急性肺损伤，仍然很常见。治疗手段有限，预防仍是主要策略。
