Uncoupling of biological oscillators: A complementary hypothesis concerning the pathogenesis of multiple organ dysfunction syndrome

Paul J. Godin, Timothy G. Buchman*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

322 Scopus citations

Abstract

Objective: To present a complementary hypothesis concerning the pathogenesis of the multiple organ dysfunction syndrome. Data Sources: Primary reports and reviews published in peer-reviewed medical and scientific journals. Hypothesis: We suggest that healthy organs behave as biological oscillators, which couple to one another during human development, and that this orderly coupling is maintained through a communications network, including neural, humoral, and cytokine components. We suggest that the systemic inflammatory response syndrome initiates disruption of communication and uncoupling, and further suggest that progression into the multiple organ dysfunction syndrome reflects progressive uncoupling that can become irreversible. Resolution of the inflammatory response and reestablishment of the communications network are necessary but may not be, by itself, sufficient to allow organs to appropriately recouple. This hypothesis is testable using existing laboratory and clinical tools.

Original languageEnglish
Pages (from-to)1107-1116
Number of pages10
JournalCritical Care Medicine
Volume24
Issue number7
DOIs
StatePublished - Jul 1996
Externally publishedYes

Keywords

  • endotoxin
  • inflammatory response
  • multiple organ dysfunction
  • pathogenicity
  • septic shock
  • systemic inflammatory response syndrome

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