Publications
Bone Failure in Critical Illness
Abstract
OBJECTIVES: The origin of systemic inflammatory response syndrome and multiple organ dysfunction syndrome is poorly understood but remains a fundamental concern in the ICU. This paper provides a critical appraisal on whether bone failure may represent an unrecognized component of systemic inflammatory response syndrome/multiple organ dysfunction syndrome. DATA SOURCES, DATA SELECTION, AND DATA EXTRACTION: Search of the PubMed database and manual review of selected articles investigating bone pathophysiology in critical illness. DATA SYNTHESIS: Bone hyperresorption is highly prevalent among critically ill patients. Bone breakdown releases numerous systemically active cytokines and bone-sequestered toxins, with the capacity to fuel inflammatory hypercytokinaemia and metabolic toxaemia. Anti-resorptive medication inhibits bone break down and preadmission anti-resorptive use is associated with superior survival among critically ill patients. CONCLUSIONS: We propose that hyperresorptive bone failure is an unrecognised component of systemic inflammatory response syndrome/multiple organ dysfunction syndrome that is causal to critical illness progression. If this hypothesis is valid, bone preservative strategies could reduce the risk of osteoporosis/fractures among ICU survivors, as well as decreasing critical illness mortality.
Type | Journal |
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ISBN | 1530-0293 (Electronic) 0090-3493 (Linking) |
Authors | Lee, P. ; Nair, P. ; Eisman, J. A. ; Center, J. R.; |
Responsible Garvan Author | (missing name) |
Publisher Name | CRITICAL CARE MEDICINE |
Published Date | 2016-01-01 |
Published Volume | 44 |
Published Issue | 12 |
Published Pages | 2270-2274 |
Status | Published in-print |
URL link to publisher's version | http://www.ncbi.nlm.nih.gov/pubmed/27355524 |
OpenAccess link to author's accepted manuscript version | https://publications.gimr.garvan.org.au/open-access/13905 |