الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Ploytrauma is defined as two or more severe injuries in at least two areas of the body.
Effects of injury is characterized by various endocrine, immunologic and metabolic alteration.
Hormone effect pathways activated by: (1) Mediators released by injured tissue.
(2) Neural and nociceptive input originating from site of injury
(3) Baroreceptor stimulation from intravascular volume depletion.
Metabolic response to injury is characterized by ebb arid flow phases. The ebb phase corresponds to the earliest moments to hour after injury. Flow phase serves to direct energy and protein substrate to preserve critical organ function and repair damaged tissues.
The persistence of systemic inflammation. The progression
of organ dysfunction, and even late mortality indicate the presence of other potent mediators, these mediators are known as cytokines which are secreted by immunocytes.
Multiple organ failure syndrome is defined as a clinical entity characterized by progressive but potentially reversible physiologic dysfunction of two or more organs or more organ systems that arises after resuscitation for acute life- threatening event.