• Tjaakje Visser, Janesh Pillay, Leo Koenderman, and Luke P H Leenen.
• Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
• Curr Opin Crit Care. 2008 Dec 1; 14 (6): 666-72.

Purpose Of ReviewMultiple organ failure is the main cause of late morbidity and mortality after severe injury. This disease state is driven by a dysfunctional immune system. Prediction of multiple organ failure on the basis of clinical parameters appears to be insufficient. A better understanding of immunological pathogenesis underlying multiple organ failure may lead to better prediction and innovation in treatment strategy in order to increase the survival of trauma patients.Recent FindingsImmune monitoring has increased the knowledge of the pathogenesis of multiple organ failure, but many mechanisms underlying its cause and development remain to be elucidated. Consequently, adequate predictive markers for diagnosis and monitoring still need to be developed.SummaryGeneral markers of inflammation including cytokines are correlated with posttraumatic complications with a low sensitivity and specificity and are, therefore, of little use as prognostic markers. Current findings regarding the functionality of immune cells are promising and might be of prognostic value in the near future.

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