• Timothy G Buchman.
• Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. buchman@msnotes.wustl.edu
• Curr Opin Crit Care. 2004 Oct 1; 10 (5): 378-82.

Purpose Of ReviewThe review considers problems in critical illness and critical care in the context of complex systems science. Normal physiology is characterized by nonlinear dynamics, and it appears that the pathophysiology of critical illness alters those dynamics.Recent FindingsRecent evidence confirms and extends the observation that the rich variability that characterizes normal physiology "decomplexifies" with critical illness. Experimental data in animals and now in humans suggests that physiologic support that mimics normal variability may reduce the severity and/or duration of the illness.SummaryPhysiologic dynamics in health and in critical illness appear to reflect complex, interconnected systems biology. Alterations in illness and during recovery may provide important clues to the underlying structure of the system. With knowledge of the structure, therapy could be better focused toward supporting both function and dynamics, offering hope for improved outcomes.Copyright 2004 Lippincott Williams & Wilkins

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