Multi-organ dysfunction syndrome (EL)

Question 1

What is multi-organ dysfunction syndrome?

Answer 1

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

Question 2

What does multi-organ dysfunction syndrome usually result from? (4)

Answer 2

• infection
• injury
• hypoperfusion
• hypermetabolism

Question 3

What are the stages of multi-organ dysfunction syndrome?

Answer 3

• initial insult - infection, injury, hypoperfusion, hypermetabolism
• this triggers a systemic inflammatory response (sepsis/SIRS)
• final stage - multi-organ dysfunction syndrome (MODS)
• summary: SIRS + infection –> sepsis –> severe sepsis –> MODS

Question 4

What are the four stages of the MODS score?
(Multi-organ dysfunction syndrome)

Answer 4

• 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 blood), acid-base disturbance, significant coagulation abnormalities
• stage 4 - vasopressor dependant, oliguria/anuria, ischaemic colitis and lactic acidosis

Question 5

What are the main investigations we do for multi-organ dysfunction syndrome? (2)

Answer 5

• monitor vital signs
• ABG may be necessary to look at hypoxaemia, hypocapnia, lactic acidosis