Multi-Organ Dysfunction Syndrome

Question 1

Define multi-organ dysfunction syndrome.

Answer 1

Multi-organ dysfunction syndrome (MODS) is also known as multiple organ failure and is altered organ function in an acutely ill patient requiring medical intervention to achieve homeostasis.

Question 2

Explain the aetiology/risk factors of multi-organ dysfunction syndrome.

Answer 2

The condition usually results from infection, injury (accident, surgery), hypoperfusion and hypermetabolism. The primary cause triggers an uncontrolled inflammatory response. Sepsis is the most common cause of MODS and may result in septic shock.

Question 3

Summarise the epidemiology of multi-organ dysfunction syndrome.

Answer 3

Epidemiology is unknown.

Question 4

Recognise the presenting symptoms of multi-organ dysfunction syndrome. Recognise the signs of multi-organ dysfunction syndrome on physical examination.

Answer 4

• *Stage 1:** The patient has increased volume requirements and mild respiratory alkalosis which is accompanied by oliguria, hyperglycemia and increased insulin requirements.
• *Stage 2:** The patient is tachypneic, hypercapnic and hypoxemic; develops moderate liver dysfunction and possible hematologic abnormalities.
• *Stage 3:** The patient develops shock with azotemia and acid-base disturbances; has significant coagulation abnormalities.
• *Stage 4:** The patient is vasopressor dependent and oliguric or anuric; subsequently develops ischemic colitis and lactic acidosis.

Question 5

Identify appropriate investigations for multi-organ dysfunction syndrome and interpret the results.

Answer 5

Investigations are to identify the cause of multi-organ dysfunction syndrome so there is a huge variety of tests you can do.

Question 6

Summarise the prognosis for patients with multi-organ dysfunction syndrome.

Answer 6

At present there is no drug or device that can reverse organ failure that has been judged by the health care team to be medically and/or surgically irreversible. Mortality varies from 30% to 100% where the chance of survival is diminished as the number of organs involved increases. Since the 1980s the mortality rate has not changed.

Question 7

Generate a management plan for multi-organ dysfunction syndrome.

Answer 7

The management of MODS requires a multidisciplinary approach that includes antibiotics for sepsis control, microcirculatory and respiratory support for reperfusion, organ-targeted drugs, and the correction of coagulation abnormalities, acid-base imbalance; metabolic issues, and electrolyte imbalance.