ABSTRACT
Progress in emergency response systems and resuscitation techniques has resulted in a significant improvement in the immediate survival of victims of severe trauma, burns, and infection. However, many early survivors develop a syndrome of progressive and sequential dysfunction of multiple organ systems that may result in prolonged morbidity or death.1 Multiple organ dysfunction syndrome (MODS) accounts for most of the lateonset deaths in critically ill patients.2,3 Large US epidemiologic studies indicate that physiologic changes, organ failure rates, and survival are similar among patients with infectious and noninfectious causes of MODS.4,5 Furthermore, organ failure, both in terms of the number of organs failing6 and the degree of organ dysfunction,6,7 is the strongest predictor of death. It is estimated that 750 000 cases of sepsis, accompanied by organ dysfunction warranting hospitalization, occur in the USA each year at an annual cost exceeding $16 billion.8
