Everything about Multiple Organ Dysfunction Syndrome totally explained
Multiple organ dysfunction syndrome (MODS), previously known as
multiple organ failure (MOF), is altered
organ function in an acutely ill patient requiring
medical intervention to achieve
homeostasis. The use of "multiple organ failure" should be avoided since that term was based upon physiologic parameters to determine whether or not a particular organ was failing.
Origin
Originally patients were classified as having
sepsis or the
sepsis syndrome. This resulted in two concepts: the
systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). These two
genes are pro-inflammatory. However, they're essential components of a normal healthy
immune response, so there's risk of increasing vulnerability to infection, which can also cause clinical deterioration.
Some have developed a
mouse model sepsis via cecal ligation and puncture (CLP). Male
Balb/c mice subjected to CLP were given an
IL-10-carrying vector or an empty control vector.
Lung,
Liver and
kidney tissue destruction were measured by assessing
myeloperoxidase and malonialdehyde activity. These last two are endogenous oxidizing compounds produced during tissue
inflammation. The authors assessed the level
neutrophil infiltration in lung and liver tissue.
IL-10 protein expression was measured using immunohistochemistry. The expression of
Tumor necrosis factor-alpha mRNA was measured at 3,8, and 24 hours after CLP using
reverse transcription polymerase chain reaction. Their results show significantly reduced organ damage by
IL-10 gene transfer, as quantified by reduced
myeloperoxidase activity in the
lung,
liver, and
kidney. The malonialdehyde level wasn't affected by the transfer into the
liver. The livers of the mice infected with the adenoviral vector showed reduced
neutrophil activity. The
lung and
kidney samples in mice carrying the gene showed lower expression of
Tumor necrosis factor-alpha mRNA. The investigators concluded that increased
IL-10 expression significantly reduced
sepsis-induced Multiple organ injury.
Pathophysiology
A definite explanation hasn't 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 (5-7 days),
gastrointestinal bleeding (10-15 days), and
renal failure (11-17 days)The
relative risk reduction was 21.8%. For patients at similar risk to those in this study (33.9% had 28-day mortality), this leads to an
absolute risk reduction of 7.4%. 13.5 patients must be treated for one to benefit (
number needed to treat = 13.5).
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to adjust these results for patients at higher or lower risk of 28-day mortality.
Prognosis
Mortality varies from 30% to 100% where the chance of survival is diminished as the number of organs involved increases. Since the 1980s the mortality rate hasn't changed.
Further Information
Get more info on 'Multiple Organ Dysfunction Syndrome'.
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