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TL;DR
This narrative review proposes that a dysregulated host/organ response (HOUR) is a common pathophysiological mechanism underlying various critical illnesses, regardless of the initial injury.
Chinese Medical Journal · 5 authors, 2 centres
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This narrative review proposes that a dysregulated host/organ response (HOUR) is a common pathophysiological mechanism underlying various critical illnesses, regardless of the initial injury.
This narrative review synthesizes current knowledge to propose a unifying concept: a host/organ unregulated response (HOUR) as a common cause of critical illness. It categorizes critical illness development into four stages: pre-disease, initiating causes, HOUR (the common cause), and critical illness. The paper argues that while initiating causes like infection or trauma are heterogeneous, the subsequent host response becomes dysregulated and leads to organ dysfunction. It discusses downstream pathways including neuroendocrine, immune, inflammatory, metabolic, and mitochondrial dysfunction. The implication is that managing this dysregulated response, rather than just the initial insult, could be key to improving outcomes. Limitations include the absence of original data, reliance on existing literature, and that therapeutic strategies remain largely theoretical or controversial.