Other terms – Multiple organ failure, Multisystem organ failure
Multiple Organ Dysfunction Syndrome is altered organ function in an acutely ill patient requiring medical intervention to achieve homeostasis.
It usually involves two or more organ systems.
The condition can result following infection, injury, hypoperfusion and hypermetabolism.
The syndrome occurs when the primary cause triggers an uncontrolled inflammatory response. In one-third of the patients no primary focus can be found.
Pathophysiology
A definite explanation has not been found. Local and systemic responses are initiated by tissue damage. Respiratory failure is common in the first 72 hours after the original insult. Following this one might see hepatic failure, gastrointestinal bleeding, and renal failure.
Treatment and Prognosis
At present there is no agent that can reverse the established organ failure. Therapy therefore is limited to supportive care. Maintaining adequate tissue oxygenation is a principal target. Starting enteral nutrition within 36 hours of admission to an Intensive care unit has reduced infectious complications.
Human recombinant activated protein C has been recently found to reduce the immediate mortality.
Mortality has been reported in 30% to 100% of the cases.
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