The First Wiggers Bernard Conference on Shock, Sepsis, and Organ Failure was envisaged as a meeting of American and European Scientists. It was named after two researchers, one from the "Old" and one from the "New World", who are wellknown for their outstanding achievements in shock research and experimental medicine. This meeting was a point of de parture for a series of workshops that will focus on two to three main topics dealt with in detail by experts in their respective fields. The First Wiggers Bernard Conference addressed three main questions: 1. Multi-organ-failure - is it a sequence of organ failures or a systemic disease? 2. Cellular events in trauma and sepsis - are they due to suppression, activation or both? 3. Mediators of organ failure - are LPS or sepsis necessary? Although many answers were given in this first session, numerous issues remain to be clarified due to the enormous complexity of the subject. How ever, the stage was set for encounters between clinicians and basic medical researchers, since theoretical knowledge will be useful to the clinician ex ploring new approaches to diagnosis, prophylaxis, and therapy. The conference could not have been organized without the generous sup port of the Immuno Company, Vienna, Austria. May we express our special thanks to Dr. Eibl, managing director and head of the research division of Immuno AG, not only for granting financial support but also for his valuable advice, encouragement, and scientific expertise.

Carl J. Wiggers

Claude Bernard
1. What is Multi-Organ-Failure - Is it a Sequence of Organ Failures or a Systemic Disease?
Clinical Manifestations and Sequences of Organ Failure
Discussion
The Specific Role of ARDS in the Development of Multiple Organ Failure
Discussion
Quantification of Organ Failure
Discussion
The Metabolic Basis of the Septic Multiple Organ Failure Syndrome: Abnormal Energetic Fuel Control, Pathophysiologic Proteolysis and Futile Cycling of Hepatically Synthesized Substrates
Discussion
Humoral and Cellular Activation in Blood Leading to Organ Failure
Discussion
Endothelium as the Interface Between Blood and Organ in the Evolution of Organ Failure
Discussion
Cellular Metabolic Responses in Endotoxemia, and a Hypothesis for the Mechanism of Hepatic Failure in Endotoxic Shock
Discussion
2. Cellular Events in Trauma and Sepsis - Suppression Versus Activation or Both ?
Posttraumatic Immune Suppression as Initiator of Organ Failure
Humoral Factors in Immune Suppression After Injury
Discussion
Activation of Neutrophils and the Role of Eicosanoids in the Initiation of Organ Failure
Discussion
Role of Xanthine Oxidase-Derived Oxidants and Granulocytes in Ischemia/Reperfusion
Discussion
Role of Proteinases in the Pathophysiology of Organ Failure
Discussion
Activation of Cellular Membrane Receptors; Intracellular Messengers and Mediators of the Response to Injury
Discussion
3. Mediators of Organ Failure - Are LPS or Sepsis Necessary ?
Experimental Induction of Whole Body Inflammation Leads to ARDS, Multiple Organ Failure and Sepsis. The ZIGI-Model in Rats and Mice
Discussion
Endotoxin-Initiated Organ Failure Responses
Discussion
Through a Glass Darkly: The Gut in Multiple Organ Failure
Discussion
Changes in Mesenteric Blood Flow Affects Translocation in Sheep
Discussion
Antagonists of Platelet-Activating Factor as Potential Therapeutic Agents in Shock
IL-1 and TNF: Mediators of LPS-Induced Neutrophil Emigration and Thrombosis
Discussion
4. Conference Summary and Concluding Remarks
Multiple Organ Failure as a Systemic Disease of Host-Defense Failure
Final Discussion.