Mediators in trauma.

Mediator release associated with polytrauma is responsible for the multifactorial process of posttraumatic organ failure. Mediator action is part of a complex network characterised by a number of major events. Tissue trauma activates specific and unspecific proteolysis in different humoral systems, such as the complement, fibrinolysis and coagulation systems as well as the kallikrein cascade. These provoke release of mediators known to stimulate cellular elements like platelets, granulocytes and macrophages. Activated phagocytes are known to release numerous tissue-damaging and toxic mediators. These are responsible for organ failure, which may terminate as a multi-organ failure syndrome.