Failures of intensive treatment of multiple organ failure: pathophysiology and the need for personalization

Abstract

Multiple organ failure (MOF) is the most severe outcome of the critical care patients of any reason (sepsis, trauma, ischemia and reperfusion), the mortality rate with this syndrome has no tendency to decrease. The review article offers, first of all, an introduction to the key research areas in which the MOF theory is currently developing (alarmines, mitochondrial dysfunction, barrier insufficiency, immunological and neurological conjugation, forms of programmed cell death, induced immunosuppression, resolution of inflammation). Studies prove the feasibility of introducing a personalized approach to the diagnosis of MOF by substantiating the endophenotype of the critical care patients on the basis of a complex of immunological, genomic and clinical indicators.