week13

Question 1

What is multiple organ failure?

Answer 1

It is the failure of one or more organs in the body, it is the most common cause of death in ICU

Question 2

What is multiple organ dysfunction syndrome (MODS)?

Answer 2

The abnormal cellular responses involving multiple organ systems, it is a sequential process and is closely related to sepsis and sepsis treatment

Question 3

What is the pathophysiology of MODS?

Answer 3

Hypoxic hypoxia which is caused by altered metabolic regulation of tissue oxygenation, causes microcirculatory injury

During Sepsis or ischemia mitochondria cause cell death rather than restore homeostasis

Question 4

What are some causes of MODS?

Answer 4

Infection				
Surgery
Injury/trauma				
Burns
Underlying medical conditions (liver or heart disease)

Question 5

What is SIRS?

Answer 5

Systematic inflammatory response syndrome is an inflammatory state affecting the whole body

Question 6

If you don’t treat SIRS what occurs?

Answer 6

Sepsis (if not treated) leads to Shock (if not treated) leads to MODS

Question 7

What are some of the signs and symptoms of SIRS?

Answer 7

Temp <35 or > 38.5
HR > 90
Tachypnoea RR >20
WWC – significantly low or high

Question 8

What is the treatment of SIRS?

Answer 8

Volume Resuscitation
Early antibiotic administration
Early goal directed therapy Rapid source identification and control
Support of major organ dysfunction

Question 9

Organ Dysfunction can be minimise through

Answer 9

Early interventions can be implemented to increase recovery outlook as the risk of death increase by 11-23% as each organ fails

Question 10

What is the organ failure cascade?

Answer 10

The organ systems from the system that most commonly fails first leading on to other organ failures

Pulmonary system → Cardiovascular → Renal → Haematological system

Question 11

What are 2 major syndromes which cause haematological dysfunction?

Answer 11

Thrombotic Microangiopathy (TMA)
Disseminated intravascular coagulation (DIC)

Question 12

What is TMA?

Answer 12

Thrombotic Microangiopathy

The formation of microvascular platelet aggregates usually caused by injury to microvascular endothelium

Question 13

What is DIC?

Answer 13

Disseminated intravascular Coagulation

Widespread activation of tissue factor dependant coagulation, it is the insufficient control of coagulation

Question 14

What is the treatment of haematological dysfunction?

Answer 14

Aggressive resuscitation – fluids/blood components/clotting factors/platelets

Question 15

What are some of the organ dysfunction scoring systems?

Answer 15

APACHE
SAPS
MPM

Question 16

What is the SOFA scoring system?

Answer 16

A scoring system which is specific to sepsis related sequential organ failure, as the score increases (with dysfunctional organs) mortality increases

Question 17

What is the treatment for MODS?

Answer 17

Shock management
Need to be aware of secondary insults – problems arise from treatment, or condition
High level of critical care management – ICU high level nursing/medical care
Prevention and management – timely treatment/effective shock resus/organ support

Question 18

What is the early treatment of infection?

Answer 18

Antimicrobial therapy – 5 times more likely to survive if effective antimicrobial therapy is used

Question 19

Neurological Dysfunction

Answer 19

Causes respiratory and cardiovascular organ dysfunction
Due to dysfunction of the sympathetic nervous system
Survivors of sepsis induced MODS may suffer cognitive impairment