Multiple Organ Failure Syndrome-Reply

In Reply.  —Systemic capillary leak syndrome is clearly a physical manifestation of the systemic inflammatory organ dysfunction response to infection and tissue injury and in patients who develop the progressive form of MOF. Beyond this physical sign, however, the role of this physical manifestation in tissue oxygenation remains largely in the experimental research domain. Clinical studies documenting this expression of the inflammatory response as a pathogenic mechanism of ischemic injury that affects outcomes in patients seem to be only in the early research phase. This is different than correlating this physical sign with an outcome or validating it as a predictor of an outcome.A review of the clinical studies indicates that this point of view also pertains to the clinical use of the various volume expanders. I would concur that more research is necessary and that appropriately designed and executed clinical studies with suitable endpoints that focus on these