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Multiple organ dysfunction syndrome
Multiple organ dysfunction syndrome (MODS), previously known as multiple organ failure (MOF), Total organ failure(TOF) or multisystem organ failure (MSOF), is when the organ function is acutely ill and the patient is required medical intervention to achieve homeostasis. It usually involves two or more organ systems.
The use of "multiple organ failure" or "multisystem organ failure" should be avoided since that phrase was based upon physiological parameters to determine whether or not a particular organ was failing.
The condition usually results from infection, injury (accident, surgery), hypoperfusion and hypermetabolism. The primary cause triggers an uncontrolled inflammatory response. Sepsis is the most common cause in operative and non-operative patients. Sepsis may result in septic shock.
Four clinical phases have been suggested:
- Stage 1 the patient has increased volume requirements and mild respiratory alkalosis which is accompanied by oliguria, hyperglycemia and increased insulin requirements.
- Stage 2 the patient is tachypneic, hypocapnic and hypoxemic; develops moderate liver dysfunction and possible hematologic abnormalities.
- Stage 3 the patient develops shock with azotemia and acid-base disturbances; has significant coagulation abnormalities.
- Stage 4 the patient is vasopressor dependent and oliguric or anuric; subsequently develops ischemic colitis and lactic acidosis.
- Intensive Care Medicine by Irwin and Rippe