СИНДРОМ ПОЛІОРГАННОЇ ДИСФУНКЦІЇ ТА ЕНДОКРИННА СИСТЕМА У ЧОЛОВІКІВ КОМБАТАНТІВ (ОГЛЯД ЛІТЕРАТУРИ)

Nataliia Seliukova; Eduard Khoroshun; Vitalii Makarov; Volodymyr Nehoduiko; Kostiantyn Gumeniuk; Maryna Boyko; Katerina Misiura

doi:10.21856/j-PEP.2025.1.07

MULTIPLE ORGAN FAILURE/DYSFUNCTION SYNDROME AND ENDOCRINE SYSTEM IN MEN-COMBATANTS

Authors

Seliukova N. Yu. SI «V. Danilevsky Institute for Endocrine Pathology Problems of the NAMS of Ukraine», Kharkiv, Ukraine; National University of Pharmacy, Kharkiv, Ukraine https://orcid.org/0000-0001-9657-6888
Khoroshun E. M. Military Medical Clinical Center of the Northern District of the Medical Forces Command, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine http://orcid.org/0000-0003-1258-1319
Makarov V. V. Military Medical Clinical Center of the Northern District of the Medical Forces Command, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine https://orcid.org/0000-0002-4224-0294
Nehoduiko V. V. Military Medical Clinical Center of the Northern District of the Medical Forces Command, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine https://orcid.org/0000-0003-4540-5207
Gumeniuk K. V. Medical Forces Command of the Armed Forces of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0001-8892-4061
Boiko M. O. SI «V. Danilevsky Institute for Endocrine Pathology Problems of the NAMS of Ukraine», Kharkiv, Ukraine https://orcid.org/0000-0001-5252-3418
Misiura K. V. SI “V. Danilevsky Institute for endocrine pathology problems of NAMS of Ukraine», Kharkiv, Ukraine https://orcid.org/0000-0002-0258-9109

DOI:

https://doi.org/10.21856/j-PEP.2025.1.07

Keywords:

combatants, multiple organ failure/dysfunction syndrome, trauma, explosion-related injuries, endocrine pathology, review

Abstract

The limited ability to provide earlier evacuation of the injured soldiers from the battlefield and their treatment causes the infections, sepsis, multiple organ failure/dysfunction syndrome (MODS development) and leads to the high death rate among combatants. Multiple organ dysfunction syndrome means that two or more organism systems are not functioning properly. As a result the duration of treatment in the intensive care unit is increased and the high death rate is extremely risen (up to 27% –100%).

The massive damage of tissues, long-term inflammation, the activation of immune system, the lack of pain relief and control of the infection complications in combatants with severe explosion-related injuries are the main causes of MODS development. Psychological and physiological stress, posttraumatic stress disorder and acute stress reactions also impact the hormonal status and general condition of the organism which slow down the healing processes.

The precise pathogenic mechanism of the MODS development is complicated and remains unexplored. The explosion-related injuries lead to development of hyper inflammatory response which is named Systemic inflammatory response syndrome (SIRS), and to the reaction of the inhibition of immune system which is named Compensatory Inflammatory Response Syndrome (CARS). When the period of hyper inflammatory response and anti-inflammatory response is over, there is a healing period which usually continues from several days to some weeks and allows to restore the homeostasis and to survive after trauma obtained. However, the hyper inflammatory response and/or anti-inflammatory response never disappear in certain percentage of patients which causes the chronic inflammation and is named Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS). As a rule, this pathology occurs in patients who were in the critical condition more than 14 days and is accompanying by significant leucopenia and inflammation. This condition can persist during several months and can lead to the later MODS and secondary infections development with further morbidity and late mortality. Abnormal immune responses in form of local or systemic inflammation can result in dysfunction of some organism system such as heart failure, acute kidney injury, endocrine disorders which is manifested by cortisol level increased, hypocalcaemia, subacute thyroiditis, “thyroid storm”, myxedema coma, glucose metabolism disorders and sex hormones secretion. These conditions demand the accurate diagnostic and appropriate treatment because their complications are considered to be crucial and can cause fatal outcome.

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Published

2025-03-15

How to Cite

Seliukova, N., Khoroshun, E., Makarov, V., Nehoduiko, V., Gumeniuk, K., Boyko, M., & Misiura, K. (2025). MULTIPLE ORGAN FAILURE/DYSFUNCTION SYNDROME AND ENDOCRINE SYSTEM IN MEN-COMBATANTS. Problems of Endocrine Pathology, 82(1), 58–66. https://doi.org/10.21856/j-PEP.2025.1.07