多系统器官衰竭(英文)课件解析.ppt

Multiple Organ Dysfunction Syndrome (MODS)多器官功能障碍综合征 Lecturer Dr. Xianmin Bu 卜献民 Definition Multiple organ dysfunction syndrome MODS: Multiple organs or systems dysfunction occur simultaneously or progressively following severe infection, severe trauma and shock. The affected organs/systems may be respiratory, cardiovascular, renal, hepatic, gastrointestinal, hematological, endocrine, and central nervous system. MODS is an important reason for the death of severe patient. The Evolution of MODS In World War I, injured soldiers died in the battlefield of profound cardiac failure. This was presumed to be caused by wound toxins, but clinical interventions were largely undefined. In World War II and to a greater extent in the Korean War, the loss of blood volume was recognized to be the primary cause of traumatic shock. battlefield casualties were resuscitated with blood and plasma until blood pressure returned to normal. As a result, more soldiers survived their initial insult; however, the severely injured often succumbed to oliguric renal failure. The Evolution of MODS 1960’s - ARDS was described in Vietnam “Shock Lung”. 1973 - Tilney described multiple organ failure (MOF) or Multi System Organ Failure (MSOF). They concluded that MOF syndrome was the result of a combination of preexisting disease and hemorrhagic shock. 1980’s - began to realize concept of sepsis. MOF was considered as a fatal expression of uncontrolled infection. 1990’s – systemic hyperinflammation became the focus, now referred to as the systemic inflammation response syndrome (SIRS). The Evolution of MODS MODS replaces “Multi System Organ Failure” or MSOF MODS is a range of dysfunctional organs, not just failure Altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention MOF and MODS Multiple organ failure (MOF):Progressive distant organ failure (initially uninvolved) following severe infectious or noninfectious insults (sev