Hemodynamic homeostasis disequilibrium in critical illness
Over millions of years, the circulatory system evolved from primitive forms into a highly specialized network capable of overcoming time-distance constraints and enhancing diffusion efficiency. This structural advancement laid the physiological foundation for the regulation of hemodynamics and syste...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-07-01
|
| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2025.1503320/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849717939350011904 |
|---|---|
| author | Jie Wang Xiaoting Wang Dawei Liu Hui Lian Guangjian Wang Zewen Tong Qingyu Deng Qirui Guo Qian Zhang Yangong Chao Wanhong Yin |
| author_facet | Jie Wang Xiaoting Wang Dawei Liu Hui Lian Guangjian Wang Zewen Tong Qingyu Deng Qirui Guo Qian Zhang Yangong Chao Wanhong Yin |
| author_sort | Jie Wang |
| collection | DOAJ |
| description | Over millions of years, the circulatory system evolved from primitive forms into a highly specialized network capable of overcoming time-distance constraints and enhancing diffusion efficiency. This structural advancement laid the physiological foundation for the regulation of hemodynamics and systemic homeostasis. Hemodynamic homeostasis is a fundamental biological process that ensures the continuous delivery of oxygen and substrates while facilitating the removal of carbon dioxide and metabolic waste. Such balance is essential for sustaining cellular metabolism and maintaining the function of vital organs throughout embryonic development and the human lifespan. Disruption of this equilibrium, primarily driven by the Host/Organ Unregulated Response (HOUR), compromises the cardiovascular-respiratory system, resulting in hemodynamic homeostasis disequilibrium. HOUR specifically targets the critical unit—a constellation of elements essential for oxygenation and cell energetics, including the microcirculation, endothelial glycocalyx, and mitochondria, impairing the oxygenation process, ultimately triggering critical illness. Although intervention targeting systemic hemodynamic variables (e.g., pressure, flow) may temporarily improve regional perfusion, restoring full homeostasis remains challenging. This is largely due to the activation of multiple positive feedback loops (e.g., coagulation cascades) and impairment of key negative feedback mechanisms (e.g., blood pressure regulation). In the presence of ongoing HOUR, inappropriate or delayed interventions may exacerbate injury and accelerate irreversible organ damage or death. Therefore, it is both essential and urgent to elucidate the initiation, recognition, progression, and modulation of hemodynamic homeostasis disequilibrium. |
| format | Article |
| id | doaj-art-85ca3c628e7c4bb5bf7b7cc76d354daf |
| institution | DOAJ |
| issn | 1664-042X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj-art-85ca3c628e7c4bb5bf7b7cc76d354daf2025-08-20T03:12:31ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-07-011610.3389/fphys.2025.15033201503320Hemodynamic homeostasis disequilibrium in critical illnessJie Wang0Xiaoting Wang1Dawei Liu2Hui Lian3Guangjian Wang4Zewen Tong5Qingyu Deng6Qirui Guo7Qian Zhang8Yangong Chao9Wanhong Yin10Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Health Care, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Health Care, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Critical Care Medicine, First Hospital of Tsinghua University, Beijing, ChinaDepartment of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Critical Care Medicine, First Hospital of Tsinghua University, Beijing, ChinaVisualized Diagnostics and Therapeutics & Artificial Intelligence Laboratory/ Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaOver millions of years, the circulatory system evolved from primitive forms into a highly specialized network capable of overcoming time-distance constraints and enhancing diffusion efficiency. This structural advancement laid the physiological foundation for the regulation of hemodynamics and systemic homeostasis. Hemodynamic homeostasis is a fundamental biological process that ensures the continuous delivery of oxygen and substrates while facilitating the removal of carbon dioxide and metabolic waste. Such balance is essential for sustaining cellular metabolism and maintaining the function of vital organs throughout embryonic development and the human lifespan. Disruption of this equilibrium, primarily driven by the Host/Organ Unregulated Response (HOUR), compromises the cardiovascular-respiratory system, resulting in hemodynamic homeostasis disequilibrium. HOUR specifically targets the critical unit—a constellation of elements essential for oxygenation and cell energetics, including the microcirculation, endothelial glycocalyx, and mitochondria, impairing the oxygenation process, ultimately triggering critical illness. Although intervention targeting systemic hemodynamic variables (e.g., pressure, flow) may temporarily improve regional perfusion, restoring full homeostasis remains challenging. This is largely due to the activation of multiple positive feedback loops (e.g., coagulation cascades) and impairment of key negative feedback mechanisms (e.g., blood pressure regulation). In the presence of ongoing HOUR, inappropriate or delayed interventions may exacerbate injury and accelerate irreversible organ damage or death. Therefore, it is both essential and urgent to elucidate the initiation, recognition, progression, and modulation of hemodynamic homeostasis disequilibrium.https://www.frontiersin.org/articles/10.3389/fphys.2025.1503320/fullhemodynamic homeostasishemodynamic homeostasis disequilibriumhypoxiacritical unitHOUR (Host/Organ Unregulated Response) |
| spellingShingle | Jie Wang Xiaoting Wang Dawei Liu Hui Lian Guangjian Wang Zewen Tong Qingyu Deng Qirui Guo Qian Zhang Yangong Chao Wanhong Yin Hemodynamic homeostasis disequilibrium in critical illness Frontiers in Physiology hemodynamic homeostasis hemodynamic homeostasis disequilibrium hypoxia critical unit HOUR (Host/Organ Unregulated Response) |
| title | Hemodynamic homeostasis disequilibrium in critical illness |
| title_full | Hemodynamic homeostasis disequilibrium in critical illness |
| title_fullStr | Hemodynamic homeostasis disequilibrium in critical illness |
| title_full_unstemmed | Hemodynamic homeostasis disequilibrium in critical illness |
| title_short | Hemodynamic homeostasis disequilibrium in critical illness |
| title_sort | hemodynamic homeostasis disequilibrium in critical illness |
| topic | hemodynamic homeostasis hemodynamic homeostasis disequilibrium hypoxia critical unit HOUR (Host/Organ Unregulated Response) |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2025.1503320/full |
| work_keys_str_mv | AT jiewang hemodynamichomeostasisdisequilibriumincriticalillness AT xiaotingwang hemodynamichomeostasisdisequilibriumincriticalillness AT daweiliu hemodynamichomeostasisdisequilibriumincriticalillness AT huilian hemodynamichomeostasisdisequilibriumincriticalillness AT guangjianwang hemodynamichomeostasisdisequilibriumincriticalillness AT zewentong hemodynamichomeostasisdisequilibriumincriticalillness AT qingyudeng hemodynamichomeostasisdisequilibriumincriticalillness AT qiruiguo hemodynamichomeostasisdisequilibriumincriticalillness AT qianzhang hemodynamichomeostasisdisequilibriumincriticalillness AT yangongchao hemodynamichomeostasisdisequilibriumincriticalillness AT wanhongyin hemodynamichomeostasisdisequilibriumincriticalillness |