Overview

• A clinical syndrome characterised by the development of progressive and potentially reversible physiologic dysfunction of 2 or more organs or organ systems that is induced by a variety of insults, including sepsis.
• Usually results from:
  • Infection Injury Hypoperfusion Hypermetabolism
• This primary cause can trigger a systemic inflammatory response (sepsis or SIRS)
• MODS is the final stage in a continuum beginning with SIRS + infection:
  • SIRS + infection --> sepsis --> severe sepsis --> MODS

Making Diagnosis

Multiple Organ Dysfunction Score

Stage 1 - increased volume requirements, mild respiratory alkalosis, oliguria, hyperglycaemia, increased insulin requirements

Stage 2 - tachypnoea, hypocapnia, hypoxaemia, moderate liver dysfunction and haematologic abnormalities

Stage 3 - shock, azotaemia (high nitrogen in the blood), acid-base disturbance, significant coagulation abnormalities

Stage 4 - vasopressor dependent, oliguria or anuria, development of ischaemic colitis and lactic acidosis

Investigations:

• Monitor vital signs
• ABG may be necessary to look at hypoxaemia, lactic acidosis etc.

Management Plan