Danny McAuley is a Consultant and Professor in Intensive Care Medicine at the Regional Intensive Care Unit at the Royal Victoria Hospital and Queen’s University of Belfast. He undertook his training in Belfast, Birmingham, London and San Francisco. He is Co-Director of Research for the UK Intensive Care Society.
The role of the endothelium as a mediator of critical illness
The systemic and pulmonary endothelium is increasingly recognised as important in both the development and resolution of critical illness and represents a potential therapeutic target for novel treatments.
Normally the endothelium plays a key role in maintaining homeostasis. Systemic and pulmonary endothelial dysfunction in the setting of critical illness results in multiple organ dysfunction. In this presentation, the following will be reviewed;
1) Evidence for the role of endothelial dysfunction in the pathogenesis of critical illness. Systemic endothelial dysfunction is implicated in the pathophysiology of sepsis and trauma, pulmonary endothelial dysfunction is involved in the development of ARDS.
2) Methods used to assess endothelial function in critical illness will be reviewed.
3) Mechanisms by which interventions may modify endothelial function will be discussed. The future potential role for treatments to modulate endothelial function in the management of the critically ill will be speculated.
In summary the aim of this review will be to highlight an important role for endothelial dysfunction in the critically ill.