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Systemic Inflammation After Trauma, Infection, and Cardiopulmonary Bypass: Is Autodestruction a Necessary Evil?

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Multiple Organ Failure

Abstract

To survive in nature all animals, inducing humans, need an efficient defense system to overcome minor trauma and common infections. It had been observed as early as ancient times that limited damage to some part of the body can lead to the collapse of vital organ systems, remote from the original ate of impact. Fever and prostration were thought to be caused by “toxins” developing within the wounds. Since the discovery of their pathogenic potential, bacteria seemed to be always present in these cases, suggesting that infection is the decisive factor prohibiting recovery. When effective antimicrobial agents became available, it was originally expected that “killing the bugs” would put an end to disease in serious infections. It was soon experienced, however, that the initial physiologic derangement caused by trauma or infection may progress and kill the host, even when at autopsy no remaining infectious focus can be demonstrated.1

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References

  1. Nuytinck JKS, Offermans XJ, Kubat K, et al: Whole-body inflammation in trauma patients: an autopsy study. Arch Surg 1988; 123: 1519–1524.

    Article  PubMed  CAS  Google Scholar 

  2. Pepe PE, Potkin RT, Reus DH, et al: Clinical predictors of the adult respiratory distress syndrome. Am J Surg 1982; 144: 124–130.

    Article  PubMed  CAS  Google Scholar 

  3. Goris RJ, te Boekhorst TP, Nuytinck JKS, et al: Multiple-organ failure: generalized autodestructive inflammation? Arch Surg 1985; 120: 1109–1115.

    Article  PubMed  CAS  Google Scholar 

  4. Bone RC, Sibbald WJ, Sprung CL: The ACCP-SCCM consensus conference on sepsis and organ failure. Chest 1992; 101: 1481–1483.

    Article  PubMed  CAS  Google Scholar 

  5. Roumen RM, Hendriks T, van der Ven-Jongekrijg J, et al: Cytokine patterns in patients after major vascular surgery, hemorrhagic shock, and severe blunt trauma: relation with subsequent adult respiratory distress syndrome and multiple organ failure. Ann Surg 1993; 218: 769–776.

    Article  PubMed  CAS  Google Scholar 

  6. Foster DM, Doig GS: Clinical trials for the evaluation of sepsis therapies. In: Vincent J-L (ed) Yearbook of Intensive Care and Emergency Medicine 1997. Berlin, Springer, 1997; 149–157.

    Chapter  Google Scholar 

  7. Van der Poll T, de Waal Malefyt R, Coyle SM, et al: Antiinflammatory cytokine responses during clinical sepsis and experimental endotoxemia: sequential measurements of plasma soluble interleukin (IL)-1 receptor type II, IL-10, and IL-13. J Infect Dis 1997; 175: 118–122.

    Article  PubMed  Google Scholar 

  8. Docke WD, Randow F, Syrbe U, et al: Monocyte deactivation in septic patients: restoration by IFN-gamma treatment. Nat Med 1997; 3: 678–681.

    Article  PubMed  CAS  Google Scholar 

  9. Karzai W, Reinhart K: Is it beneficial to augment or to inhibit neutrophil function in severe infections and sepsis? In: Vincent J-L (ed) Yearbook of Intensive Care and Emergency Medicine 1997. Berlin, Springer, 1997; 123–132.

    Chapter  Google Scholar 

  10. Gillinov AM, Redmond JM, Winkelstein JA, et al: Complement and neutrophil activation during cardiopulmonary bypass: a study in the complement-deficient dog. Ann Thorac Surg 1994; 57: 345–352.

    Article  PubMed  CAS  Google Scholar 

  11. Sundaresan M, Yu ZX, Ferrans VJ, et al: Requirement for generation of H2O2 for platelet-derived growth factor signal transduction. Science 1995; 270: 296–299.

    Article  PubMed  CAS  Google Scholar 

  12. Christman JW, Lancaster LH, Blackwell TS: Nuclear factor kappa B: a pivotal role in the systemic inflammatory response syndrome and new target for therapy. Intensive Care Med 1998; 24: 1131–1138.

    Article  PubMed  CAS  Google Scholar 

  13. Moncada S, Palmer RM, Higgs EA: Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol Rev 1991; 43: 109–142.

    PubMed  CAS  Google Scholar 

  14. Biemond BJ, Levi M, Ten Cate H, et al: Complete inhibition of endotoxin-induced coagulation activation in chimpanzees with a monoclonal Fab fragment against factor VII/VIIa. Thromb Haemost 1995; 73: 223–230..

    PubMed  CAS  Google Scholar 

  15. Anrather D, Millan MT, Palmetshofer A, et al: Thrombin activates nuclear factor-kappa B and potentiates endothelial cell activation by TNF. J Immunol 1997; 159: 5620–5628.

    PubMed  CAS  Google Scholar 

  16. Heideman M, Saravis C, Clowes GHA, et al: Effect of non-viable tissue and abscesses on complement depletion and the development of bacteremia. J Trauma 1982; 22: 527–532.

    Article  PubMed  CAS  Google Scholar 

  17. Smedley LA, Tonnessen RA, Sandhaus RA: Neutrophil-mediated injury to endothelial cells. J Clin Invest 1986; 77: 1233–1243.

    Article  Google Scholar 

  18. Dore M, Korthuis RJ, Granger DN, et al: P-selectin mediates spontaneous leukocyte rolling in vivo. Blood 1993; 82: 1308–1316.

    PubMed  CAS  Google Scholar 

  19. Mulligan MS, Varani J, Warren JS, et al: Roles of β2-integrins of rat neutrophils in complement-and oxygen radical-mediated acute inflammatory injury. J Immunol 1992; 148: 1847–1857.

    PubMed  CAS  Google Scholar 

  20. Gilmont RR, Dardano A, Engle JS, et al: TNF-alpha potentiates oxidant and reperfusion-induced endothelial cell injury. J Surg Res 1996; 61: 175–182.

    Article  PubMed  CAS  Google Scholar 

  21. Wedmore CV, Williams TJ: Control of vascular permeability by polymorphonuclear leukocytes in inflammation. Nature 1981; 89: 646–650.

    Article  Google Scholar 

  22. Anderson BO, Brown JM, Harken AH: Mechanisms of neutrophilmediated tissue injury. J Surg Res 1991; 51: 170–179.

    Article  PubMed  CAS  Google Scholar 

  23. Nathan C: Secretoryproducts of macrophages. J Clin Invest 1987; 79: 319–326.

    Article  PubMed  CAS  Google Scholar 

  24. Law MM, Cryer HG, Abraham E: Elevated levels of soluble ICAM-1 correlate with the development of multiple organ failure. J Trauma 1994; 37: 100–110.

    Article  PubMed  CAS  Google Scholar 

  25. Baue AE, Gunther B, Haiti W, et al: Altered hormonal activity in severely ill patients after injury or sepsis. Arch Surg 1984; 119: 1125–1132.

    Article  PubMed  CAS  Google Scholar 

  26. Van der Poll T, Lowry SF: Epinephrine inhibits endotoxininduced IL-1 beta production: roles of tumor necrosis factor-alpha and IL-10. Am J Physiol 1997; 273: R1885–R1890.

    PubMed  Google Scholar 

  27. Van der Poll T, Levi M, Dentener M, et al: Epinephrine exerts anticoagulant effects during human endotoxemia. J Exp Med 1997; 185: 1143–1148.

    Article  PubMed  Google Scholar 

  28. Kirklin JK, Westaby S, Blackstone EH, et al: Complement and the damaging effects of cardiopulmonary bypass. J Thorac Cardiovasc Surg 1983; 86: 845–857.

    PubMed  CAS  Google Scholar 

  29. Haslett C: Resolution of acute inflammation and the role of apoptosis in the tissue fate of granulocytes. Clin Sci (Colch) 1992; 83: 639–648.

    PubMed  CAS  Google Scholar 

  30. Meduri GU: The role of the host defense response in the progression and outcome of ARDS: pathophysiological correlations and response to glucocorticoid treatment. Eur Respir J 1996; 9: 2650–2670.

    Article  PubMed  CAS  Google Scholar 

  31. Grimm S, Baeuerle PA: The inducible transcription factor NF-kappa B: structure-function relationship of its protein subunits. BiochemJ 1993; 290: 297–308.

    CAS  Google Scholar 

  32. Medvedev AE, Flo T, Ingalls RR, et al: Involvement of CD 14 and complement receptors CR3 and CR4 in nuclear factor-kappa B activation and TNF production induced by lipopolysaccharide and group B streptococcal cell walls. J Immunol 1998; 160: 4535–4542.

    PubMed  CAS  Google Scholar 

  33. De Maio A: The heat-shock response. New Horiz 1995; 3: 198–207.

    PubMed  Google Scholar 

  34. Chandel NS, Maltepe E, Goldwasser E, et al: Mitochondrial reactive oxygen species trigger hypoxia-induced transcription. Proc Natl Acad Sci USA 1998; 95: 11715–11720.

    Article  PubMed  CAS  Google Scholar 

  35. Wan S, LeClerc JL, Vincent JL: Inflammatory response to cardiopulmonary bypass: mechanisms involved and possible therapeutic strategies. Chest 1997; 112: 676–692.

    Article  PubMed  CAS  Google Scholar 

  36. Blackwell TS, Christman JW: The role of nuclear factor-kappa B in cytokine gene regulation. Am J Respir Cell Mol Biol 1997; 17: 39

    Google Scholar 

  37. Sturm JA, Wisner DH, Oestern HJ, et al: Increased lung capillary permeability after trauma: a prospective clinical trial. J Trauma 1986; 26: 409–418.

    Article  PubMed  CAS  Google Scholar 

  38. Nuytinck JKS, Goris RJ, Redl H, et al: Posttraumatic complications and inflammatory mediators. Arch Surg 1986; 121: 886–890.

    Article  PubMed  CAS  Google Scholar 

  39. Pape HC, Remmers D, Kleemann W, et al: Posttraumatic multiple organ failure: a report on clinical and autopsy findings. Shock 1994; 2: 228–234.

    Article  PubMed  CAS  Google Scholar 

  40. Roumen RM, Hendriks T, Wevers RA, et al: Intestinal permeability after severe trauma and hemorrhagic shock is increased without relation to septic complications. Arch Surg 1993; 128: 453–457.

    Article  PubMed  CAS  Google Scholar 

  41. Van der Poll T, Levi M, van Deventer SJ: Coagulopathy: disseminated intravascular coagulation. In: Fein AM, Abraham EM, Balk RA, et al (eds) Sepsis and Multiorgan Failure. Baltimore, Williams & Wilkins, 1997; 255–265.

    Google Scholar 

  42. Simms HH, D’Amico R: Increased PMN CD11b/CD18 expression following post-traumatic ARDS. J Surg Res 1991; 50: 362–367.

    Article  PubMed  CAS  Google Scholar 

  43. Botha AJ, Moore FA, Moore EE, et al: Early neutrophil sequestration after injury: a pathogenetic mechanism for multiple organ failure. J Trauma 1995; 39: 411–417.

    Article  PubMed  CAS  Google Scholar 

  44. Howard RJ, Crain C, Franzini DA, et al: Effects of cardiopulmonary bypass on pulmonary leukostasis and complement activation. Arch Surg 1988; 123: 1496–1501.

    Article  PubMed  CAS  Google Scholar 

  45. Natanson C, Danner RL, Reilly JM, et al: Antibiotics versus cardiovascular support in a canine model of human septic shock. Am J Physiol 1990; 259: 1440–1447.

    Google Scholar 

  46. Roumen RM, Redl H, Schlag G, et al: Inflammatory mediators in relation to the development of multiple organ failure in patients after severe blunt trauma. Crit Care Med 1995; 23: 474–480.

    Article  PubMed  CAS  Google Scholar 

  47. Heideman M, Norder-Hanssen B, Bengtson A, et al: Terminal complement complexes and anaphylatoxins in septic and ischemic patients. Arch Surg 1988; 123: 188–192.

    Article  PubMed  CAS  Google Scholar 

  48. Yodice PC, Astiz ME, Kurian BM, et al: Neutrophil rheologic changes in septic shock. Am J Respir Crit Care Med 1997; 155: 38–42.

    Article  PubMed  CAS  Google Scholar 

  49. Goldie AS, Fearon KC, Ross JA, et al: Natural cytokine antagonists and endogenous anti-cytokine core antibodies in sepsis syndrome. JAMA 1995; 274: 172–177.

    Article  PubMed  CAS  Google Scholar 

  50. Offner F, Phillipe J, Vogelaers D: Serum tumor necrosis factor levels in patients with infectious disease and septic shock. J Lab Clin Med 1990; 116: 100–105.

    PubMed  CAS  Google Scholar 

  51. Meduri GU, Kohler G, Headley S, et al: Inflammatory cytokines in the BAL of patients with ARDS: persistent elevation over time predicts poor outcome. Chest 1995; 108: 1303–1314.

    Article  PubMed  CAS  Google Scholar 

  52. Jansen MJ, Hendriks T, Vogels MT, et al: Inflammatory cytokines in an experimental model for the multiple organ dysfunction syndrome. Crit Care Med 1996; 24: 1196–1202.

    Article  PubMed  CAS  Google Scholar 

  53. Okusawa S, Gelfand JA, Ikejima T, et al: Interleukin 1 induces a shock-like state in rabbits. J Clin Invest 1988; 81: 1162–1172.

    Article  PubMed  CAS  Google Scholar 

  54. Meduri GU, Headley S, Kohler G, et al: Persistent elevation of inflammatory cytokines predicts a poor outcome in ARDS: plasma IL-1-beta and IL-6 levels are consistent and efficient predictors of outcome over time. Chest 1995; 107: 1062–1073.

    Article  PubMed  CAS  Google Scholar 

  55. Blackwell TS, Christman JW: Sepsis and cytokines: current status. BrJ Anaesth 1996; 77: 110–117.

    Article  CAS  Google Scholar 

  56. Rosenbloom AJ, Pinsky MR, Bryant JL, et al: Leukocyte activation in the peripheral blood of patients with cirrhosis of the lier and SIRS: correlation with serum interleukin-6 levels and organ dysfunction. JAMA 1995; 274: 58–65.

    Article  PubMed  CAS  Google Scholar 

  57. Gomez Jimenez J, Martin MC, Sauri R, et al: InterleuMn-10 and the monocyte-macrophage-induced inflammatory response in septic shock. J Infect Dis 1995; 171: 472–475.

    Article  PubMed  CAS  Google Scholar 

  58. Donnelly SC, Strieter RM, Reid PT: The association between mortality rates and decreased concentrations of interleukin-10 and interleukin-1 receptor antagonist in the lung fluids of patients with the adult respiratory distress syndrome. Ann Intern Med 1996; 125: 191–196.

    PubMed  CAS  Google Scholar 

  59. Van Goor H, Borm Vjj, Meer van der J, et al: Coagulation and fibrinolytic responses in human peritoneal fluid and plasma to bacterial peritonitis. Br J Surg 1996; 83: 113–135.

    Article  Google Scholar 

  60. Holzheimer RG, Schein M, Wittman DH: Inflammatory response in peritoneal exudate and plasma of patients undergoing planned relaparotomy for severe secondary peritonitis. Arch Surg 1995; 130: 1314–1320.

    Article  PubMed  CAS  Google Scholar 

  61. Kossmann T, Hans VH, Imhof HG, et al: Intrathecal and serum interleukin-6 and the acute-phase response in patients with severe traumatic brain injuries. Shock 1995; 4: 311–317.

    Article  PubMed  CAS  Google Scholar 

  62. Marie C, Fitting C, Cheval C, et al: Presence of high levels of leukocyte-associated interleukin-8 upon cell activation and in patients with sepsis syndrome. Infect Immun 1997; 65: 865–871.

    PubMed  CAS  Google Scholar 

  63. Duswald KH, Jochum M, Schramm W, et al: Released granulocytic elastase: an indicator of pathobiochemical alterations in septicemia after abdominal surgery. Surgery 1985; 98: 892–899.

    PubMed  CAS  Google Scholar 

  64. Pacher R, Redl H, Frass M, et al: Relationship between neopterin and granulocyte elastase plasma levels and the severity of multiple organ failure. Crit Care Med 1989; 17: 221–226.

    Article  PubMed  CAS  Google Scholar 

  65. Tanaka H, Sugimoto H, Yoshioka T, et al: Role of granulocyte elastase in tissue injury in patients with septic shock complicated by multiple-organ failure. Ann Surg 1991; 213: 81–85.

    Article  PubMed  CAS  Google Scholar 

  66. Waydhas C, Nas-Kolb D, Jochum M, et al: Inflammatory mediators, infection, sepsis, and multiple organ failure after severe trauma, Arch Surg 1992; 127: 460–467.

    Article  PubMed  CAS  Google Scholar 

  67. Headley AS, Tolley E, Meduri GU: Infections and the inflammatory response in acute respiratory distress syndrome. Chest 1997; 111: 1306–1321.

    Article  PubMed  CAS  Google Scholar 

  68. Luna CM, Vujacich P, Niederman MS, et al: Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia. Chest 1997; 111: 676–685.

    Article  PubMed  CAS  Google Scholar 

  69. Oudemans-van Straaten HM, Jansen PG, Hoek FJ, et al: Intestinal permeability, circulating endotoxin, and postoperative systemic responses in cardiac surgery patients. J Cardiothorac Vasc Anesth 1996; 10: 187–194.

    Article  Google Scholar 

  70. Bennett-Guerrero E, Ayuso L, Hamilton-Davies C, et al: Relationship of preoperative antiendotoxin core antibodies and adverse outcomes following cardiac surgery. JAMA 1997; 277: 646–650.

    Article  PubMed  CAS  Google Scholar 

  71. Meakins JL, Marshall JC: The gastrointestinal tract: the “motor” of MOF. Arch Surg 1986; 121: 197–201.

    Google Scholar 

  72. Corson RJ, Paterson IS, O’Dwyer STO, et al: Lower limb ischemia and reperfusion alters gut permeability. Eur J Vasc Surg 1992; 6: 158–163.

    Article  PubMed  CAS  Google Scholar 

  73. Gaussorgues P, Gueugniaud PY, Vedrinne JM, et al: Bacteremia following cardiac arrest and cardiopulmonary resuscitation. Intensive Care Med 1988; 14: 575–577.

    Article  PubMed  CAS  Google Scholar 

  74. Beckman JS, Beckman TW, Chen J, et al: Apparent hydroxyl radical production by peroxynitrite: implications for endothelial injury from nitric oxide and superoxide. Proe Natl Acad Sci USA 1990; 87: 1620–1624.

    Article  CAS  Google Scholar 

  75. Van Bebber IPT, Boekholtz WK, Goris RJ, et al: Neutrophil function and lipid peroxidation in a rat model of multiple organ failure. J Surg Res 1989; 47: 471–475.

    Article  PubMed  Google Scholar 

  76. Wang JH, Redmond HP, Watson RW, Bouchier-Hayes D: Induction of human endothelial cell apoptosis requires both heat shock and oxidative stress responses. Am J Physiol 1997; 272: C1543–C1551.

    PubMed  CAS  Google Scholar 

  77. Nuytinck JKS, Goris RJ, Weerts JG, et al: Generalized microvascular injury by activated complement and hypoxia: the basis of the adult respiratory distress syndrome and multiple organ failure? Br J Exp Pathol 1986; 67: 537–548.

    PubMed  CAS  Google Scholar 

  78. Hopf HW, Hunt TK, West JM, et al: Tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg 1997; 132: 997–1004.

    Article  PubMed  CAS  Google Scholar 

  79. Allen DB, Maguire JJ, Mahdavian M, et al: Hypoxia and acidosis limit neutrophil bacterial killing mechanisms. Arch Surg 1997; 132: 991–996.

    Article  PubMed  CAS  Google Scholar 

  80. Shoemaker WC, Appel PL, Kram HB, et al: Elective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest 1988; 94: 1176–1186.

    Article  PubMed  CAS  Google Scholar 

  81. Hayes MA, Timmins AC, Yau EH, et al: Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 1994; 330: 1717–1722.

    Article  PubMed  CAS  Google Scholar 

  82. Leverve XM, Mustafa I, Peronnet F: Pivotal role of lactate in aerobic energy metabolism. In: Vincent J-L (ed) Yearbook of Intensive Care and Emergency Medicine, 1998. Berlin, Springer Verlag, 1998; 588–598.

    Chapter  Google Scholar 

  83. Ronco JJ, Fenwick JC, Tweeddale MG, et al: Identification of the critical oxygen delivery for anaerobic metabolism in critically ill septic and nonseptic humans. JAMA 1993; 270: 1724–1730.

    Article  PubMed  CAS  Google Scholar 

  84. Beerthuizen GIJM, Goris RJ, Beyer HJM, et al: Differences in regional oxygen supply, oxygen consumption and blood flow during the onset of E. colt sepsis. In: Schlag G, Redl H (eds) First Vienna Shock Forum. New York, Iiss, 1987; 495–502.

    Google Scholar 

  85. Lam C, Tyml K, Martin C, et al: Microvascular perfusion is impaired in a rat model of normotensive sepsis. J Clin Invest 1994; 94: 2077–2083.

    Article  PubMed  CAS  Google Scholar 

  86. Ince C, Sinaasappel M: Microcirculatory oxygenation and shunting in sepsis and shock. Crit Care Med 1999 (in press).

    Google Scholar 

  87. Lundblad R, Wang MY, Kvalheim G, et al: Granulocyte colonystimulating factor improves myelopoiesis and host defense in fulminant intra-abdominal sepsis in rats. Shock 1995; 4: 68–73.

    Article  PubMed  CAS  Google Scholar 

  88. Toda H, Murata A, Matsuura N, et al: Therapeutic efficacy of granulocyte colony stimulating factor against rat cecal ligation and puncture model. Stem Cells 1993; 11: 228–234.

    Article  PubMed  CAS  Google Scholar 

  89. Nelson S, Belknap SM, Carlson RW, et al: A randomized controlled trial of filgrastim as an adjunct to antibiotics for treatment of hospitalized patients with community-acquired pneumonia: CAP Study Group. J Infect Dis 1998; 178: 1075–1080.

    Article  PubMed  CAS  Google Scholar 

  90. Echtenacher B, Mannel DN, Hultner L: Critical protective role of mast cells in a model of acute septic peritonitis. Nature 1996; 381: 75–77.

    Article  PubMed  CAS  Google Scholar 

  91. Nieuwenhuijzen GA, Knapen MF, Hendriks T, et al: Elimination of various subpopulations of macrophages and the development of multiple-organ dysfunction syndrome in mice. Arch Surg 1997; 132: 533–539.

    Article  PubMed  CAS  Google Scholar 

  92. Ziegler M, Fisher CJ, Sprang CL: Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. N Engl J Med 1991; 324: 429–436.

    Article  PubMed  CAS  Google Scholar 

  93. Fisher CJ, Agosti JM, Opal SM, et al: Treatment of septic shock with the tumor necrosis factor receptor: Fc fusion protein. N Engl J Med 1996; 334: 1697–1702.

    Article  PubMed  CAS  Google Scholar 

  94. Christman JW, Holden EP, Blaekwell TS: Strategies for blocking the systemic effects of cytokines in the sepsis syndrome. Crit Care Med 1995; 23: 955–963.

    Article  PubMed  CAS  Google Scholar 

  95. Bone RC, Fisher CJ Jr., Clemmer TP, et al: A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 1987; 317: 653–658.

    Article  PubMed  CAS  Google Scholar 

  96. Bernard GR, Luce JM, Sprung CL, et al: High-dose corticosteroids in patients with the adult respiratory distress syndrome. N Engl J Med 1987; 317: 1565–1570.

    Article  PubMed  CAS  Google Scholar 

  97. Bollaert PE, Charpentier C, Levy B, et al: Reversal of late septic shock with supraphysiologic doses of hydrocortisone. Crit Care Med 1998; 26: 645–650.

    Article  PubMed  CAS  Google Scholar 

  98. Meduri GU, Headley AS, Golden E, et al: Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA 1998; 280: 159–165.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. E. E. de Bel
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  2. R. J. A. Goris
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Editors and Affiliations

  1. Department of Surgery, St. Louis University Hospital, St. Louis, Missouri, 63110, USA

    Arthur E. Baue MD (Professor Emeritus) (Professor Emeritus)

  2. Department of Surgery, Klinikum Grosshadern, University of Munich, Munich, D-81377, Germany

    Eugen Faist MD (Professor) (Professor)

  3. Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, New Mexico, 87131, USA

    Donald E. Fry MD (Professor and Chairman) (Professor and Chairman)

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de Bel, E.E., Goris, R.J.A. (2000). Systemic Inflammation After Trauma, Infection, and Cardiopulmonary Bypass: Is Autodestruction a Necessary Evil?. In: Baue, A.E., Faist, E., Fry, D.E. (eds) Multiple Organ Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1222-5_7

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  • DOI: https://doi.org/10.1007/978-1-4612-1222-5_7

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