UNCOUPLING OF BIOLOGICAL OSCILLATORS - A COMPLEMENTARY HYPOTHESIS CONCERNING THE PATHOGENESIS OF MULTIPLE ORGAN DYSFUNCTION SYNDROME

Objective: To present a complementary hypothesis concern ing the patho genesis of the multiple organ dysfunction syndrome, Data Sources: Prim ary reports and reviews published in peer-reviewed medical and scienti fic journals. Hypothesis: We suggest that healthy organs behave as bio logical oscillators, which couple to one another during human developm ent, and that this orderly coupling is maintained through a communicat ions network, including neural, humoral, and cytokine components, We s uggest that the systemic inflammatory response syndrome initiates disr uption of communication and uncoupling, and further suggest that progr ession into the multiple organ dysfunction syndrome reflects progressi ve uncoupling that can become irreversible, Resolution of the inflamma tory response and reestablishment of the communications network are ne cessary but may not be, by itself, sufficient to allow organs to appro priately recouple, This hypothesis is testable using existing laborato ry and clinical tools.