title: [Mediators in septic shock: strategies of securing them and assessment of their causal significance].
abstract: More than 100 different mediators are discussed as being responsible for the progression of the septic shock syndrome. A new concept is described to establish the causal role of a single mediator by using a decision tree which excludes different non-causal associations (different kinds of bias and chance). By definition of several criteria and methodological standards, the published studies on mediator release/formation could be analysed and evaluated (meta-analysis). Furthermore, the classical concept of one cause--one disease (Koch-Dale) is extended to a concept of multiple determining factors. The role of a single mediator can be assessed quantitatively by notation of conditional probabilities in the presence of other causal factors. A mediator can be classified as a necessary, sufficient or contributory determinant in septic shock. Improved therapeutic concepts can be expected from this approach.
mesh_terms: D001679:Biogenic Amines / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism; D004731:Endotoxins / Q000097:blood; D005227:Fatty Acids / Q000097:blood; D006801:Humans; D010455:Peptides / Q000097:blood; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood*
chemical_list: D001679:Biogenic Amines; D001798:Blood Proteins; D004731:Endotoxins; D005227:Fatty Acids; D010455:Peptides
vernacular_title: Mediatoren beim septischen Schock: Strategien zu ihrer Sicherung und zur Einschätzung ihrer kausalen Bedeutung.