CC Concepts: MODS Flashcards
True or False: The progression of MODS reflects a dysregulation of the balance between pro-inflammatory and anti-inflammatory agents, with a predominance of proinflammatory mediators only.
False, while initially an increase in pro-inflammatory mediators leading to SIRS, the dysregulation between inflammation and coagulation leading to endothelial activation/injury and the formation of microthromboses leading to organ failure.
What pattern of organ failure is often associated with what order?
Lungs, liver, GIT, and then kidney
What dysfunction is often seen with the lungs in patients with MODS?
Increased pulmonary capillary permeability, leading to alveolar collapse, reduced lung compliance, shunting, hypoxia pulmonary vasoconstriction, and hypoxemia
What dysfunction is often seen with the heart in patients with MODS?
Early contractile dysfunction, leading to biventricular dilation, and a reduced ejection fraction
In patients with MODS with cardiac dysfunction, will they be sensitive to increased preload and catecholamines?
Yes, but they are well reduced in response
What dysfunction is often seen with the liver in patients with MODS?
Decreased perfusion leads to a temporary acute dysfunction causing impaired gluconeogenesis and glycolysis, reduced synthetic and metabolic functions, and coagulopathy
What dysfunction is often seen with the gastrointestinal tract in patients with MODS?
Clinical signs often include ileus, ulceration, intolerance to feeding, vomiting and diarrhea
What dysfunction is often seen with the kidneys in patients with MODS?
Hypoperfusion leads to vasoconstrictive responses, ischemic necrosis, and sloughing of tubular cells
Management and treatment options for MODS include?
Restoring effective circulating volume, maintaining tissue perfusion, appropriate ventilation, nutritional supplementation, plasma filtration, glucocorticoid administration
