[Causes and therapy of organ failure: mediators, their role and therapeutic implications as exemplified by the infected patient].

Mediators from the coagulation system, the complement system, the kallikrein-kinin system and the arachidonic acid metabolism are made responsible for the pathogenesis of organ failure (ARDS) following sepsis. Products from these systems influence, directly or indirectly, vascular tone and permeability, especially in the pulmonary circulation. Besides these mediators, toxic oxygen species and proteases released from activated granulocytes and macrophages injure endothelial cells and provoke vascular leakage.