Multiple Organ Dysfunction Syndrome (MODS)



Multiple Organ Dysfunction Syndrome

Introduction

Multiorgan dysfunction syndrome (MODS) is a clinical situation described as a secondary phenomenon to the rapid progress and advances made in recent decades on the physiology, diagnosis and therapeutic support in patients with severe disease. In 1991, given the confusion in the terminology used to define the processes that were taking with systemic inflammatory response syndrome (SIRS), a conference were held consensus, establishing a set of basic definitions and substituting the term "organ failure" by SDMO (Silvestri, & Saene, 2010).

Against any external aggression, the body tries to control it through two mechanisms: nonspecific response called inflammation humoral and cellular, another specific antibody response that alters the genetic code of some cells of the defense system and is an immune response. Currently thought to be before an attack occurs uncontrolled activation of the inflammatory response (SIRS), but there is also anti-inflammatory response syndrome (CARS). The exaggerated response of SIRS can lead to MODS.

It usually requires the involvement of two or more organs for diagnosis, and there are now lots of scales defining which organs are affected and what level of dysfunction are presented. The MODS usually present with pulmonary dysfunction, if the aggression persists is usually added cardiovascular dysfunction, renal, hepatic, coagulation, central nervous system, and metabolism, gastrointestinal, neuroendocrine and musculoskeletal systems. There are a number of causes that frequently trigger this syndrome as well as a number of factors contribute to the causes and prevention of these factors is essential to reduce the appearance of the syndrome (Marik, 2010).

Currently there is no clear treatment of this syndrome, although numerous studies are underway aimed at blocking the release of certain proinflammatory mediators and trying to neutralize some anti-inflammatory responses.

Discussion

According to (Gando, 2010) the care of critically ill patients has progressed markedly in recent decades. It has more specialized human resources and technological resources more complex and expensive to provide measures for surveillance, diagnosis, support and treatment (mechanical ventilation, artificial nutrition, mechanical ventricular support, dialysis, immunotherapy, etc.) Which extend the time allowed survival, to severe patients, who for twenty or thirty years died during the first hours or days of their disease? However, it has persisted "Multiple Organ Dysfunction Syndrome" (MODS), also called multiple organ failure syndrome or multisystem failure. This syndrome is the final pathway that kills the majority of patients hospitalized in intensive care; particularly surgical patients complicated with sepsis or multiple trauma, determine high costs of hospitalization and rehabilitation and exert noticeable impact on family and social medical staff, nursing (Kümpers & Hafer, 2010 ).

There are many recent advances in the understanding of MODS. However, there are controversies on issues such as scales prognosis, monitoring (Swan - Ganz and gastric tonometry), mechanical ventilation, oxygen transport and consumption, nutritional support and protection rena1. This review of the SDMO aims to present the current state of knowledge, basic and clinical, more commonly accepted history, epidemiology, diagnosis, prevention, current management and possible treatment measures that appear in the future, with a general approach applicable to different areas ...