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Role of infection and bleeding in multiple organ involvement and failure

Department of Radiation Emergency Medicine, Research Center for Radiation Emergency Medicine, National Institute of Radiological Sciences, 263-8555 Japan

Correspondence: Makoto Akashi, MD, PhD, Department of Radiation Emergency Medicine, Research Center for Radiation Emergency Medicine, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba-city, Chiba, 263-8555 Japan. E-mail: akashi@nirs.go.jp

Whole body exposure to high dose radiation causes combined injury; multiple organs are involved, depending on their sensitivity to radiation. The general current concept of multiple organ failure (MOF) includes the gradual and sequential failure of virtually all organs after external insults. MOF develops not as a consequence of the external insult itself, but rather owing to the host's response to the insult, and is closely tied to the phenomenon recognised clinically as "inflammation". This inflammation is caused by trauma, thermal or chemical burns, pancreatitis, infection, etc. Despite the development of modern intensive care, the mortality of patients with MOF remains high. Moreover, the exact mechanisms of MOF remain unknown. This review will focus on the possible roles of infection and bleeding in multi-organ involvement and failure.