Autonomic dysfunction: A relevant component in multiple organ dysfunction syndrome

Abstract

In our article We need to know more about autonomic dysfunction in our critically ill patients [1] in the 1999 issue of this Yearbook, we postulated that autonomic dysfunction may have a relevance beyond just being an epiphenomen in these patients, and listed the questions to which answers may prove or disprove this hypothesis: Is the impairment of autonomic function caused by sepsis or multiorgan failure? If so, can a blunted autonomic function predict mortality in multiple organ dysfunction syndrome (MODS)? Is the autonomic function in MODS confounded by age or application of drugs? Can our pharmacological treatment strategies improve autonomic dysfunction? Now, eight years later, we have gained many new insights into the intriguing interplay of cardiovascular reflexes that mediate the autonomic dysfunction seen in MODS and sepsis, so that we can now answer at least some of the aforementioned questions. © 2007 Springer Science + Business Media Inc.