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Multiple Organ Dysfunction Syndrome (MODS)

Multiple Organ Dysfunction Syndrome (MODS). Jianzhong Sheng MD, PhD Department of Pathophysiology School of Medicine Zhejiang University. Definition. Dysfunction or failure of multiple organ or system happened simultaneously or sequentially due to various etiological factors. Etiology.

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Multiple Organ Dysfunction Syndrome (MODS)

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  1. Multiple Organ Dysfunction Syndrome(MODS) Jianzhong Sheng MD, PhD Department of Pathophysiology School of Medicine Zhejiang University

  2. Definition Dysfunction or failure of multiple organ or system happened simultaneously or sequentially due to various etiological factors.

  3. Etiology • Infection: Gram positive/negative bacteria, fungal, Virus • Shock :hemorrhage, etc. • Allergy • Burns • Trauma • Severe acute pancreatitis

  4. Classification of MODS • Immediate Type (Primary)：Dysfunction are happened simultaneously in two or more organs due to primary disease. • Delayed type (Secondary）：Dysfunction happened in a organ, other organs sequentially happened dysfunction or failure. • Accumulation type：Dysfunction leaded by chronic disease.

  5. Immediate Type Not related to SIRS Coup injury with chemical or physical factors No time interval from disease ARDS+ARF or ARDS+ARF+DIC+LF Delayed type Not the direct outcome from injury Relating to SIRS（systemic inflammatory response syndrome） Time interval existed from primary disease Attention Accumulation type • Accumulation • Irreversible ARDS: acute respiratory distress syndrome ARF: acute renal failure LF: liver failure

  6. Mechanism

  7. Injury factors Inflammatory mediators priming SIRS leading to MODS Vascular permeability↑＋ PMNchemotaxis Adhensive molecules PMN Mono / Macrophage elastase PLA2 oxygen free radicals TNF IL－8 IL－1 IL－6 Endothelium PAF DIC Tissue injury Liver： acute phase Remote organ injury PMN PAF, platelet activating factor polymorphonucleocyte

  8. Common Manifestations of MODS

  9. Diagnosis of Criteria

  10. Organ/ system dysfunction and failure

  11. GLASGOW SCORE

  12. Treatments of MODS

  13. Combined therapy • Correction of ischemia: fluid resuscitation, mechanical ventilation • Prevention of infection：drainage, antibiotics • Interruption of pathological reaction：hemofiltration • Stabilization of internal environment：water, electrolyte, acid-base imbalance • Regulation of immunity：cellular and humor

  14. Support of organ function • Ventilator • Artificial kidney • Artificial liver • Protection of enteral mucosa • Drugs of protection of heart

  15. Thanks!

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