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Endotoxin-induced organ injury

GHOSH, SUNIT FFARCS; LATIMER, RAYMOND D. FFARCS; GRAY, BEVERLY M. FFARCS; HARWOOD, ROBERT J. FFARCS; ODURO, AMO FFARCS

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Objective To review the effects of endotoxemia on the major organ systems of the body and discuss potential mechanisms of tissue injury.

Design Appraisal of 60 articles representing a cross section of studies relating to in vivo and in vitro responses to endotoxin.

Main Methods Cell cultures, isolated tissue preparations, animal and human studies.

Results Endotoxemia results in the activation of numerous cellular and hematogenous mediators. These mediators range from prostaglandins, thromboxanes, and leukotrienes, to complement components. Tumor necrosis factor may be responsible for initiating many of the observed responses to endotoxin. Species and tissue specificity are a prominent feature of the response to endotoxin.

Conclusions No single agent can yet be implicated as the common mediator of endotoxin-induced organ injury. Endotoxin initiates the elaboration of a cascade of secondary mediators that amplify the response to the initial insult. The relative importance of individual agents as mediators of the response to endotoxin varies with the experimental model studied. (Crit Care Med 1993; 21:S19-S24)

From the Department of Anaesthesia, Papworth Hospital, Cambridge, UK.

© Williams & Wilkins 1993. All Rights Reserved.