MODS Part 1 (2) - Health Variations 4 - PDF

Health Variations 4 Multi Organ Dysfunction Syndrome (MODS)- Part 1  Commonwealth of Australia Copyright Act 1968 WARNING This material has been reproduced and communicated to you by or on behalf...

Health Variations 4 Multi Organ Dysfunction Syndrome (MODS)- Part 1  Commonwealth of Australia Copyright Act 1968 WARNING This material has been reproduced and communicated to you by or on behalf of Western Sydney University under Part VB of the Copyright Act 1968 (the Act). The material in this communication may be subject to copyright under the Act. Any further reproduction or communication of this material by you may be the subject of copyright protection under the Act. Do not remove this notice. Multi Organ Dysfunction Syndrome (MODS) MODS is the progressive dysfunction of two or more organ systems as a result of an uncontrolled inflammatory response to severe illness or injury. Organ dysfunction can progress to organ failure and death. Multiple organ dysfunction syndrome (MODS) is the failure of two or more organ systems in an acutely ill patient such that homeostasis cannot be maintained without intervention. MODS is defined by the simultaneous presence of physiologic dysfunction and/or failure of two or more organs. The risk of death associated with MODS is 54% when two organ systems fail and increases to 100% when five organ systems fail. Organ failure that persist more than 24hrs Mortality risk increases with the accrual of failing organs The prognosis worsens with increased duration of organ failure Causes of MODS Sepsis and septic shock (most common) Any type of shock Severe inflammatory conditions such as pancreatitis and trauma Other less common causes: Toxins from envenomation (snake bite), Myoglobin in rhabdomyolysis Profound physical injury to cells e.g., nuclear radiation, heat exposure Types of MODS MODS Primary Secondary (direct injury to an organ) (consequence of widespread systemic inflammation) Pathogenesis of MODS Insult/injury to organ Systemic Response Systemic inflammatory response syndrome (SIRS) Overwhelming insult Host Excessive Inadequate Defences MODS A d e Death q u a Death t e Insult controlled Pathophysiology of MODS Excessive inflammatory response Excessive production of inflammatory cells and biochemical mediators Endothelial and organ damage and hypermetabolism Vasodilation, Capillary permeability, impaired microvascular circulation Impaired tissue perfusion, Oxygen supply to cells Anerobic cellular changes Pathogenesis of MODS Craft et al., (2023) Understanding Pathophysiology Pathophysiology of MODS Pathogenesis of multiple organ dysfunction syndrome (MODS). GI, Gastrointestinal; MDF, myocardial depressant factor; PAF, platelet-activating factor; WBCs, white blood cells. (Modified from McCance K, Huether S. Pathophysiology: The Biologic Basis for Disease in Adults and Children. 8th ed. St. Louis, MO: Elsevier; 2019.) References Craft, J. A. et al. (2023) Understanding pathophysiology. 4e. Australia and New Zealand edition. Chatswood, NSW: Elsevier Australia. Linton, A. D. (2020). Medical-surgical nursing (7th edition. ed.). St. Louis, Missouri : Elsevier, 2020. Loscalzo, J., Fauci, A. S., Kasper, D. L., Hauser, S., Longo, D. L., & Jameson, J. L. (2022). Harrison's principles of Internal Medicine (21st edition. ed.). New York McGraw Hill Education, 2022 Penman, I. D. et al. (2023) Davidson’s principles and practice of medicine. 24th edition. Ian D. Penman et al. (eds.). London: Elsevier.