Multi-Organ Failure (MOF) Flashcards
MODS
- multi-organ dysfunction syndrome
- (multi-organ failure)
SIRS
- systemic inflammatory response syndrome
- can be caused by infection, inflammation, tissue injury, ischemia
SIRS in the context of infection is known as what?
- sepsis!
What is severe sepsis?
- sepsis with organ dysfunction
What is septic shock?
- severe sepsis with hypotension
Organ dysfunction in the lungs is known as:
- ARDS (acute respiratory distress syndrome)
- (acute lung injury)
What is the pathophysiology behind ARDS?
- pulmonary edema that leads to impaired oxygenation
How many stages of ARDS are there? What does each entail?
- 2 stages
- 1st stage: exudative phase; edema, impaired gas exchange
- 2nd stage: fibrotic phase; due to proliferation of fibroblasts and alveolar type II cells, pulmonary compliance is reduced, gas exchange worsens
How do manage ARDS?
- treat the underlying cause
- give the patient O2
- mechanical ventilation
- prevent iatrogenic infection
Organ dysfunction of the CVS presents as:
- septic shock
What is the pathophysiology behind septic shock?
- decreased vascular resistance and increased capillary permeability (due to inflammation) results in massive fluid extravasation = hypovalemia
How do we manage septic shock?
- treat the underlying cause*
- fluid/volume resuscitation, O2, inotropes (to increase cardiac contractility), vasopressors (increase resistance)
Organ dysfunction of the renal system is known as:
- AKI (acute kidney injury)
What is the pathophysiology behind AKI?
- pre, intra, or post-renal
- hypoperfusion, ATN, urinary obstruction, respectively
How do we manage AKI?
- treat the underlying cause
- fluid/volume resuscitation, avoid nephrotoxic drugs, maintain renal perfusion, dialysis if needed
Organ dysfunction of the nervous system most commonly presents as:
- alterations in the level of consciousness
Organ dysfunction of the GIT results in what? What is bacterial translocation?
- the gut stops working
- normal gut flora may enter the blood stream (this is bacterial translocation)
In regards to hematology, what can occur in MODS/MOF?
- DIC (disseminated intravascular coagulation) can result from the inappropriate activation of coagulation
What are the two types of therapies used in treating MODS/MOF? What is the purpose of each?
- 1) disease modifying therapies: treat the underlying cause (fix fractures, antibiotics, drain infections, etc.)
- 2) organ support therapies: keep the patient alive while the disease modifying therapies run their course (O2, IV fluids, ventilation, dilation, etc.)
