title: The effect of evolving trauma care on the development of multiple organ dysfunction syndrome.
abstract: BACKGROUND
  Multiple organ dysfunction syndrome (MODS) is still a major threat to polytrauma patients, since sepsis-related organ failure is the most common cause of late mortality in these patients. In this article, the development of trauma surgery and evolution of trauma care from early total care to damage control surgery is discussed. Increasing knowledge of the pathophysiology of trauma has enabled us to identify the inflammatory response induced by trauma. By understanding the pathophysiology, we may be able to fully comprehend the origin of multiple organ dysfunction related sepsis. Further, it is important to appreciate the influence of surgery on the inflammatory response induced by trauma, and subsequently on the development of inflammatory complications. It is crucial to offer the polytrauma patient the appropriate type of surgery at the right time to prevent further deterioration.
  
  
  CONCLUSIONS
  MODS is still highly lethal, and once it has developed it is difficult to treat, so it is vital to be able to predict its occurrence. If we knew how to predict MODS, we might be able to develop strategies to prevent this syndrome.
authors.affiliation: Department of Trauma Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands. kwessem@umcutrecht.nl.
authors.forename: K J P
authors.initials: KJ
authors.lastname: van Wessem
authors.affiliation: Department of Trauma Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands.
authors.forename: L P H
authors.initials: LP
authors.lastname: Leenen
keywords: Inflammatory response; Organ failure; Polytrauma
references.citation: Shock. 1997 Sep;8(3):165-9
references.pmid: 9377162
references.citation: Am J Surg. 2002 Jun;183(6):622-9
references.pmid: 12095590
references.citation: Crit Care Med. 2010 Nov;38(11):2139-45
references.pmid: 20693886
references.citation: Pharmacol Rev. 2000 Mar;52(1):91-112
references.pmid: 10699156
references.citation: Injury. 2007 Dec;38(12):1358-64
references.pmid: 18048038
references.citation: J Trauma. 2001 May;50(5):792-800
references.pmid: 11371834
references.citation: Intensive Care Med. 2004 Jan;30(1):96-102
references.pmid: 14605804
references.citation: JAMA Surg. 2013 Oct;148(10):947-54
references.pmid: 23965658
references.citation: Cochrane Database Syst Rev. 2013 Mar 28;(3):CD007438
references.pmid: 23543551
references.citation: Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007438
references.pmid: 20091634
references.citation: J Thromb Haemost. 2013 Jun;11(6):1172-82
references.pmid: 23581432
references.citation: J Trauma. 2001 Jun;50(6):989-1000
references.pmid: 11426112
references.citation: J Bone Joint Surg Am. 1989 Mar;71(3):336-40
references.pmid: 2925704
references.citation: J Trauma Acute Care Surg. 2013 Jan;74(1):113-20; discussion 1120-2
references.pmid: 23271085
references.citation: J Trauma. 1998 Aug;45(2):291-301; discussion 301-3
references.pmid: 9715186
references.citation: Am Surg. 1997 Dec;63(12):1109-12; discussion 1112-3
references.pmid: 9393261
references.citation: J Trauma Acute Care Surg. 2013 Mar;74(3):774-9
references.pmid: 23425734
references.citation: Ann Surg. 1992 May;215(5):476-83; discussion 483-4
references.pmid: 1616384
references.citation: Ann Surg. 2007 Sep;246(3):491-9; discussion 499-501
references.pmid: 17717453
references.citation: J Immunol. 2007 Sep 15;179(6):3966-72
references.pmid: 17785834
references.citation: J Trauma. 1998 May;44(5):874-82
references.pmid: 9603092
references.citation: Trials. 2011 Oct 11;12:223
references.pmid: 21988742
references.citation: J Trauma. 2000 Nov;49(5):969-78
references.pmid: 11086798
references.citation: J Trauma. 2005 Dec;59(6):1365-71; discussion 1371-4
references.pmid: 16394910
references.citation: J Leukoc Biol. 2000 Jul;68(1):58-64
references.pmid: 10914490
references.citation: J Trauma Acute Care Surg. 2012 Jan;72(1):235-41
references.pmid: 22310132
references.citation: Surgery. 1995 Aug;118(2):358-64; discussion 364-5
references.pmid: 7638753
references.citation: Crit Care Med. 1996 Jul;24(7):1125-8
references.pmid: 8674323
references.citation: J Pathol. 2006 Nov;210(3):325-33
references.pmid: 16981239
references.citation: Arch Surg. 2005 May;140(5):432-8; discussion 438-40
references.pmid: 15897438
references.citation: J Trauma. 2002 Sep;53(3):452-61; discussion 461-2
references.pmid: 12352480
references.citation: Shock. 2006 Dec;26(6):558-64
references.pmid: 17117129
references.citation: Injury. 2005 Jun;36(6):691-709
references.pmid: 15910820
references.citation: Curr Opin Crit Care. 2012 Dec;18(6):647-50
references.pmid: 23037876
references.citation: Immunol Lett. 2009 Jun 30;125(1):31-9
references.pmid: 19501120
references.citation: J Trauma. 2010 Jun;68(6):1425-38
references.pmid: 20539186
references.citation: Arch Surg. 1997 Dec;132(12):1263-9; discussion 1269-70
references.pmid: 9403528
references.citation: J Trauma. 2009 Aug;67(2):221-7; discussion 228-30
references.pmid: 19667872
references.citation: J Trauma. 2003 Jul;55(1):7-13
references.pmid: 12855874
references.citation: Surg Clin North Am. 2014 Feb;94(1):131-53
references.pmid: 24267502
references.citation: J Trauma. 2009 Nov;67(5):1013-21
references.pmid: 19901662
references.citation: Crit Care. 2010;14(4):R150
references.pmid: 20687920
references.citation: Curr Opin Anaesthesiol. 2011 Apr;24(2):219-23
references.pmid: 21293264
references.citation: Shock. 1998 Aug;10(2):79-89
references.pmid: 9721973
references.citation: Unfallchirurg. 1994 May;97(5):244-9
references.pmid: 8052860
references.citation: Arch Surg. 2006 Nov;141(11):1132-40
references.pmid: 17116807
references.citation: J Trauma. 1982 Nov;22(11):895-903
references.pmid: 6754962
references.citation: Lancet. 2006 Jul 8;368(9530):157-69
references.pmid: 16829300
references.citation: Arch Surg. 1985 Oct;120(10):1109-15
references.pmid: 4038052
references.citation: J Trauma. 2010 Jun;68(6):1328-32; discussion 1332-4
references.pmid: 20539176
references.citation: J Trauma. 1999 Jan;46(1):42-8
references.pmid: 9932682
references.citation: Thromb Haemost. 2009 Jan;101(1):36-47
references.pmid: 19132187
references.citation: Chirurg. 1999 Nov;70(11):1287-93
references.pmid: 10591766
references.citation: J Trauma. 1993 Apr;34(4):540-7; discussion 547-8
references.pmid: 8487339
references.citation: Nature. 2010 Mar 4;464(7285):104-7
references.pmid: 20203610
references.citation: Shock. 2013 Jul;40(1):21-7
references.pmid: 23603769
references.citation: Ann Surg. 1993 May;217(5):576-84; discussion 584-6
references.pmid: 8489321