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In 150 patients admitted to an ICU phospholipase A serum activity was measured daily. The correlation between the increase of phospholipase A serum activity and the severity of adult respiratory distress syndrome (ARDS) and the incidence of acute renal failure (ARF), two important target systems in multiple organ failure (MOF) syndrome was studied as well as the efficacy of a treatment with phospholipase A inhibitors (methylprednisolone and dexamethasone). The results of this study show that there exists a statistically significant correlation between the increase of phospholipase A activity and the incidence of multiple organ failure. Inhibitory treatment ameliorates the organ function for a short time without any change of long-term outcome. The results could not clarify whether the rise of the mother enzyme of the arachidonic acid metabolism is only an epiphenomenon of multiple organ failure or the causative agent itself.