Multi-organ dysfunction syndrome

Question 1

Define

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

Causes

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

Epidemiology

Answer 3

Not very common

Question 4

Symptoms

Answer 4

Multiple Organ Dysfunction Score

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 5

Investigations

Answer 5

Monitor vital signs

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