ABSTRACT
Arachidonic acid is one of several fatty acids that are constituents of cell membranes. This fatty acid is relatively abundant in cell membranes and accounts for approximately 20% of the total membrane fatty acids in rabbit alveolar macrophages and human monocytes. The pattern of synthesis of eicosanoids in sepsis is more variable than that induced by bolus endotoxin injection and appears to reflect the particular paradigm of the septic process. Tumor necrosis factor, cachectin is now recognized as one of the principal endogenous mediators of endotoxic shock. The pathophysiologic events ameliorated by the pharmacologic agents include thrombocytopenia, pulmonary hypertension, depressed cardiac output, hypotension, decreased renal blood flow, decreased glomerular filtration rate, renal glomerular fibrin deposition and renal glomerular micro-thrombi. The potential beneficial effect of high-dose corticosteroid therapy in the treatment of septic shock is controversial. Corticosteroids exert part of their anti-inflammatory effect by enhancing the production of calpactins, calcium-dependent phospholipid binding proteins.
