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Care of the critically ill patient has considerably changed over the last decades with advances in ventilatory support, antimicrobial therapy, inotropic drugs and improved renal support. The survival, however, of patients presenting with major trauma or sepsis and developing the syndrome of multiple organ failure (MOF) remains poor, although this may partially be due to more severely ill patients being admitted to the intensive therapy unit (ITU). In its final stages, shock, regardless of itsdoi:10.1136/pgmj.65.770.875 pmid:2694144 pmcid:PMC2429562 fatcat:4rax2nk325eb7l2nzj7jxinmtu