Semin Respir Crit Care Med 2011; 32(5): 581-586
DOI: 10.1055/s-0031-1287866
© Thieme Medical Publishers

Organ Failure in the ICU: Cellular Alterations

James N. Fullerton1 , Mervyn Singer2
  • 1Division of Medicine, Centre for Clinical Pharmacology, Rayne Institute, London, United Kingdom
  • 2Department of Intensive Care Medicine, University College London, London, United Kingdom
Further Information

Publication History

Publication Date:
11 October 2011 (online)


The physiological and biochemical abnormalities that constitute multiple organ failure represent cellular perturbations that, importantly, need to be reconciled with a lack of significant cell death together with availability but impaired utilization of oxygen. In conjunction with the relatively rapid ability of the organ to recover in surviving patients, a paradigm of metabolic shutdown triggered by a decrease in mitochondrial energy production appears increasingly valid. This review discusses data demonstrating temporal changes in oxygen utilization through the septic process, evidence for mitochondrial derangements, and recovery of mitochondrial function preceding clinical recovery.


Mervyn Singer, M.D. , F.R.C.P. 

Department of Intensive Care Medicine, University College London

Cruciform Bldg., Gower St., London WC1E 6BT, UK

Email: [email protected]