Multiple Organ Dysfunction Syndrome
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton, Uchechukwu Chukwuemeka and Carina Therese Magtibay
Introduction[edit | edit source]
Multiple organ dysfunction syndrome (MODS) is a systemic, dysfunctional inflammatory response that requires long intensive care unit (ICU) stay. It is characterized with high mortality rate depending on the number of organs involved.
It has been recognized that organ failure does not occur as an all-or-none rule, but rather a range of organ dysfunction exists resulting in clinical organ failure.[1]
Multiple organ dysfunction syndrome is the clinical consequence of a dysregulated inflammatory response, triggered by clinically diverse factors with the main pillar of management being invasive organ support.
During the last years, the advances in the clarification of the molecular pathways that trigger, mitigate, and determine the outcome of MODS have led to the increasing recognition of MODS as a distinct disease entity with distinct etiology, pathophysiology, and potential future therapeutic interventions.
Given the lack of effective treatment for MODS, its early recognition, the early intensive care unit admission, and the initiation of invasive organ support remain the most effective strategies of preventing its progression and improving outcomes[2].
Causes[edit | edit source]
Almost any disease that results in tissue injury may result in MODS
Sepsis; Major trauma; Burns; Pancreatitis; Aspiration syndromes; Extracorporeal circulation (e.g. cardiac bypass); Multiple blood transfusion; Ischaemia–reperfusion injury; Autoimmune disease; Heat-induced illness; Eclampsia; Poisoning/toxicity[3]
Injury>> shock >> whole body hypoperfusion >> resuscitation >> reperfusion of ischaemic gut >> release of cytokines (IL6, IL8
and IL10) >> proinflammatory lipids and proteins from the reperfused splanchnic bed >> these mediators return to vascular
circulation via lymphatics >> prime PMNs >> PMNs mobilise into vascular circulation >> a significant neutrophillia at 3 h
postinjury >> ‘‘vulnerable window’’ >> A second hit during this period??: cipitate MOF, eutrophillia normally
resolves without endorgan damage.
Yes >> pre No >>
Figure 1. Causes, mechanism and types of multiorgan dysfunction syndrome.
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References[edit | edit source]
- ↑ El-Menyar A, Al Thani H, Zarour A, Tuma M, AbdulRahman H, Parchani A, Peralta R, Latifi R. Multiple Organ Dysfunction Syndrome (MODS): is it preventable or inevitable?.Available from:https://file.scirp.org/pdf/IJCM_2013010210123433.pdf (accessed 28.2.2021)
- ↑ Gourd NM, Nikitas N. Multiple organ dysfunction syndrome. Journal of intensive care medicine. 2020 Dec;35(12):1564-75.Available from: https://journals.sagepub.com/doi/10.1177/0885066619871452 (accessed 28.2.2021)
- ↑ In the fast lane MODS Available from:https://litfl.com/multiple-organ-dysfunction-syndrome/ (accessed 28.2.2021)
