![]() ![]() Clearly, ‘cross-talk’ between organs is part of the normal physiology of a large multicellular organism, with physiological mechanisms responsible for maintenance of whole organism homeostasis. It could mean many things in differing circumstances. However, while “organ cross-talk” is becoming a widely used term, it is often employed with little detailed understanding. More recently, there has been an interest in the bi-directional impact of organ dysfunction and its treatment on the function of other organ systems, a process termed “organ cross-talk.” Behind this concept lie two important observations: firstly that organ injuries may potentiate, resulting in a far greater burden of illness than if the effects of dysfunction of different organs were merely added, and, secondly, that there may be specific pathophysiological pathways of organ cross-talk that could be targets for specific intervention. ![]() There has been a longstanding appreciation of the importance of providing effective early treatment of primary conditions while avoiding secondary injury to prevent a spiral toward progressive organ dysfunction and death. ![]() Managing the conflicting demands of multi-organ support is the bread and butter of modern critical care and intensivists are very familiar with the concept of escalating increase in risk of death with the presence or acquisition of additional ‘organ failures’ (Ferreira et al. Even when the reason for ICU admission is only to support a single organ system there is invariably potential for dysfunction of other organ systems, either directly, due to the primary disease, or indirectly from the distant effects of the primary organ failure or of organ support therapies such as sedation or invasive mechanical ventilation. MODS is a frequent consequence of presentation with circulatory or septic shock, or as a serious complication of organ hypoperfusion and systemic inflammatory responses during major surgery. Multi-organ failure, better termed multi-organ dysfunction syndrome (MODS)- reflecting a graduation in severity of organ injuries, is one of the defining features of critical illness. ![]()
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