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During sepsis, physiologic changes in pH and temperature and structural changes in the respiratory chain enzymes impair cellular bioenergetic capacity which can lead to organ dysfunction and failure (Muravchick, 2006).  In the setting of sepsis, there is depression of the microcirculation causing regional hypoxia and problems with oxygen extraction by the cell even when systemic oxygenation is maintained.  During hypoxia, cells may adopt a "hibernation-like state."  Initially this state is reversible but if the septic stress is prolonged and the microcirculation left uncorrected, this adaptation is more difficult to turn around and organ dysfunction can occur (Ince, 2005).  In addition, nitric oxide and other compounds secreted from cells during sepsis are toxic to mitochondrial function (Muravchick, 2006; Brealey, 2002).

Defects in mitochondrial function can also affect immune function (Muravchick, 2006; Vernon, 2006).

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