Multiple Organ Dysfunction Syndrome

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton, Uchechukwu Chukwuemeka and Carina Therese Magtibay  

Introduction

Multiple organ dysfunction syndrome (MODS) is a syndrome, associated with the failure of one or more organ systems. Failure of these multiple organ systems is not necessarily related to the initial injury or disease process. MODS results from of a dysregulated inflammatory response, triggered by diverse factors.

• No fully effective therapy has been developed that modulates this inflammatory response, incidence, or severity of MODS.
• In current ICU practice, treatment is focused on prevention and treating individual organ dysfunction as it develops.
• MODS is the leading cause of morbidity and mortality in current ICU practice.

Given the lack of effective treatment for MODS, its early recognition, early ICU admission, and the initiation of invasive organ support remain the most effective strategies for preventing its progression and improving outcomes.

Aetiology

The pathophysiology of MODS is not completely known. The dysregulated immunological response is a crucial factor in the pathophysiology of post-injury MODS.

Almost any disease that results in tissue injury may result in MODS examples being: Sepsis; Major trauma; Burns; Pancreatitis; Extracorporeal circulation (e.g. cardiac bypass); Multiple blood transfusion; Autoimmune disease; Heat-induced illness; Eclampsia; Poisoning/toxicity

Symptoms

The patient may display some of the following symptoms depending on which organs are affected:

• Altered mental state;
• Decrease in renal perfusion (decrease in urine output);
• Respiratory deterioration;
• Decrease in cardiac function
• Deranged metabolic status
• Compromised fluid balance
• Pale, clammy, peripherally cool skin and faint pedal pulses
• Decrease in cardiac output (e.g. low blood pressure, arrhythmia).

Management and Treatment

MODS is difficult to treat, escalates quickly, and is often fatal. Therefore, early detection is crucial in preventing its progression (Wang et al. 2017).

Positive patient outcomes rely on immediate recognition, ICU admission, and invasive organ support.

Management and treatment may include:

• Identifying and treating the underlying causes, comorbidities, or complications;
• Fluid resuscitation to increase perfusion
• Support care and monitoring including Multi-organ support; Mechanical or non-invasive ventilation; Maintaining fluid homeostasis; Renal replacement therapy.