Multi-Organ Dysfunction Syndrome

Question 1

Define MODS

Answer 1

• A clinical syndrome characterised by the development of progressive and potentially reversible physiologic dysfunction of 2 or more organs or organ systems that is induced by a variety of insults, including sepsis

Question 2

What are the causes/risk factors of MODS?

Answer 2

Usually results from:
• Infection 
• Injury
• Hypoperfusion 
• Hypermetabolism 

This primary cause can trigger a systemic inflammatory response (sepsis or SIRS)
MODS is the final stage in a continuum beginning with SIRS + infection:
SIRS + infection –> sepsis –> severe sepsis –> MODS

Question 3

What are the signs and symptoms of MODS?

Answer 3

Stage 1
• increased volume requirements
• mild respiratory alkalosis
• oliguria
• hyperglycaemia
• increased insulin requirements 

Stage 2 
• tachypnoea
• hypocapnia
• hypoxaemia
• moderate liver dysfunction and haematologic abnormalities 

Stage 3 
• shock
• azotaemia (high nitrogen in the blood)
• acid-base disturbance
• significant coagulation abnormalities 

Stage 4
• vasopressor dependent
• oliguria or anuria
• development of ischaemic colitis and lactic acidosis

Question 4

What investigations are carried out for MODS?

Answer 4

• monitor vital signs

* ABG - hypoxaemia, lactic acidosis