Multi-Organ Dysfunction Syndrome

Question 1

Definition

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

Aetiology/risk factors

Answer 2

· Usually results from:
o Infection
o Injury
o Hypoperfusion
o 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:
o SIRS + infection –> sepsis –> severe sepsis –> MODS

Question 3

Epidemiology

Answer 3

Not very common

Question 4

Presenting symptoms and signs (score system)

Answer 4

o Stage 1 - increased volume requirements, mild respiratory alkalosis, oliguria, hyperglycaemia, increased insulin requirements

o Stage 2 - tachypnoea, hypocapnia, hypoxaemia, moderate liver dysfunction and haematologic abnormalities

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

o Stage 4 - vasopressor dependent, oliguria or anuria, development of ischaemic colitis and lactic acidosis

Question 5

Investigations

Answer 5

· Monitor vital signs

· ABG may be necessary to look at hypoxaemia, lactic acidosis etc