Pediatric sepsis and multiple organ dysfunction syndrome

Systemic inflammatory response syndrome may be viewed as the systemic expre ssion of cytokine signals that normally function on an autocrine or paracri ne level. Sepsis is defined as systemic inflammatory response syndrome caus ed by an infection. Multiple organ dysfunction syndrome may represent the e nd stage of severe systemic inflammatory response syndrome or sepsis. Many cells are involved, including endothelial cells and leukocytes and multiple proinflammatory and antiinflammatory mediators (cytokines, oxygen free rad icals, coagulation factors; and so forth), Various pathophysiologic mechani sms have been postulated. The most popular theorys that the inflammatory pr ocess loses its autoregulatory capacity; however, microcirculatory dysregul ation and apoptosis may also be important, and a new paradigm posits a comp lex nonlinear system. Many new treatments have been studied recently. The u sefulness of immune modulating diets remains to be evaluated, Molecular imm unomodulation is still of unclear value. The therapy of sepsis:and multiple organ dysfunction syndrome remains mainly supportive. Curr Opin Pediatr 20 01 13:247-253 (C) 2001 Lippincott Williams & Wilkins, Inc.