Multiple Organ Dysfunction Syndrome

Most common cause of death for pts in ICU

Incidence 11-40% of adult ICU pts

Risk factors: (1) Severe illness at time of ICU admission; (2) severe sepsis or infection at time of ICU admission; (3) old age

Associated with trauma, sepsis, shock, male sex, African American race, chronic health conditions, malnutrition, use of immunosuppressants

Labile hemodynamics

Difficulty with oxygenation and ventilation

Malnutrition

Altered drug metabolism

Volume status

Drug metabolism

Antibiotic selection

Difficulty cross-matching blood products

Transfusion reactions

MODS is a dynamic process; clinical course and causes are highly variable.

Defined by the presence of altered organ function in an acutely ill pt such that homeostasis cannot be maintained without intervention.

A potentially reversible physiologic derangement involving two or more organ systems not involved in the original disorder as cause for ICU admission.

Septic shock is the main cause of MODS in the ICU.

Represents a failure of homeostasis resulting from dysfunction of the neuroendocrine and immune systems.

A combination of tissue hypoxia, exaggerated inflammatory response, and end-organ damage from ischemia and necrosis, resulting in macrovascular and microvascular changes.