How is multiple organ dysfunction characterized in bacterial sepsis?

Updated: Feb 05, 2019
  • Author: Amber Mahmood Bokhari, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Multiple organ dysfunction syndrome (MODS) is characterized by progressive organ dysfunction in a severely ill patient, with failure to maintain homeostasis without intervention. It is the end stage in infectious conditions (sepsis, septic shock) and noninfectious conditions (eg, SIRS due to pancreatitis). The greater the number of organ failures, the higher the mortality risk, with the greatest risk associated with respiratory failure requiring mechanical ventilation. MODS can be classified as primary or secondary. [3]

Primary MODS is the direct result of identifiable injury or insult with early organ dysfunction (eg, renal failure due to a nephrotoxic agent or liver failure due to a hepatotoxic agent).

Secondary MODS is organ failure that has no attributable cause and is a consequence of the host's response (eg, acute respiratory distress syndrome [ARDS] in individuals with pancreatitis).

The following parameters are used to assess individual organ dysfunction:

  • Respiratory system: Partial pressure of arterial oxygen (PaO 2)/fraction of inspired oxygen (FiO 2) ratio
  • Hematology: Platelet count, coagulation panel (prothrombin time and partial thromboplastin time)
  • Liver: Serum bilirubin
  • Renal: Serum creatinine (or urine output)
  • Brain: Glasgow coma score
  • Cardiovascular: Hypotension and vasopressor requirement

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