Goris R J, te Boekhorst T P, Nuytinck J K, Gimbrère J S
Arch Surg. 1985 Oct;120(10):1109-15. doi: 10.1001/archsurg.1985.01390340007001.
As multiple-organ failure (MOF) has been generally associated with sepsis, the importance of bacterial sepsis was evaluated retrospectively in 55 trauma and 37 intra-abdominal-sepsis patients with MOF. The severity of MOF was graded, and an analysis was made of day of onset, incidence, severity, sequence, and mortality of organ failures. No difference was found between groups in sequence, severity, or mortality of organ failures. In contrast, bacterial sepsis was found in 65% of intra-abdominal-sepsis patients but only in 33% of trauma patients. It is concluded that sepsis is probably not the essential cause of MOF. Instead, an alternative hypothesis is presented involving massive activation of inflammatory mediators by severe tissue trauma or intra-abdominal sepsis, resulting in systemic damage to vascular endothelia, permeability edema, and impaired oxygen availability to the mitochondria despite adequate arterial oxygen transport.
由于多器官功能衰竭（MOF）通常与脓毒症相关，因此对55例创伤患者和37例患有MOF的腹腔内脓毒症患者的细菌脓毒症重要性进行了回顾性评估。对MOF的严重程度进行了分级，并对器官衰竭的发病日、发病率、严重程度、顺序和死亡率进行了分析。两组在器官衰竭的顺序、严重程度或死亡率方面未发现差异。相比之下，65%的腹腔内脓毒症患者发现有细菌脓毒症，而创伤患者中仅为33%。得出的结论是，脓毒症可能不是MOF的根本原因。相反，提出了另一种假说，即严重的组织创伤或腹腔内脓毒症导致炎症介质大量激活，尽管动脉氧输送充足，但仍导致血管内皮细胞的系统性损伤、通透性水肿和线粒体氧供应受损。
