Correlating functional staging to effective treatment of acute surgical illness

Background: Proinflammatory and anti-inflammatory events may eventually tri gger host response, which acting via a broad spectrum of complex biological processes and molecular interactions may either enhance or resolve the sym ptoms of acute surgical illness (ASI). Staging the sequence of biological e vents that take place at the cellular level during the development of ASI m ay provide leads to effective stage-specific treatments. In line with the h ypothesis that proper timing of therapeutic intervention may be crucial to the management of the disease, we have attempted in this review to correlat e functional staging to effective treatment of ASI. Data source: The present report proposes a conceptual synthesis on the biog enesis and treatment of ASI that is based on known molecular and cellular a spects of human inflammatory sequence and patient data from clinical trials . It also introduces proper timing of therapeutic intervention as a potenti ally important determinant for the successful outcome of the disease proces s. Conclusions: Progress in understanding the biogenesis of ASI did not result in successful therapeutic developments as yet. The challenge ahead should be a better understanding of the dynamics of the various processes and regu lators in appropriate animal and clinical models of ASI, in order to proper ly intervene and direct effective therapies for the benefit of critically i ll patients. (C) 2001 Excerpta Medica, Inc. All rights reserved.