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Sepsis and Organ Dysfunction pp 17–33Cite as

Sepsis and Organ Dysfunction. The Challenge Continues

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Abstract

The simultaneous poor functioning of more than one organ or system is an extremely common occurrence in patients admitted to intensive care units, and indeed is one of the main causes of death of such patients. This condition, originally indicated by the acronym MOFS (Multi Organ Failure Syndrome), has recently been renamed as MODS (Multi Organ Dysfunction Syndrome) [1]. This change of nomenclature was principally due to a) the need to express the concept of evolution, contained in the term dysfunction, which reflects the spectrum of intermediate situations existing between full function and full-blown failure and b) the lack of uniformity over a definition of organ failure, which according to the author ranges from a variation in a given parameter to the need for supportive therapy [1]. Nevertheless, beyond the semantic differences, in the light of the most recent animal and clinical studies it appears clear that a) in the vast majority of cases the changes which cause an organ to dysfunction can also cause its failure and that, b) once established the dysfunction can progress towards failure even after the removal of its cause. Thus, in the last analysis, MODS seems to be the final common pathway of a heterogeneous series of clinical events, including shock, mechanical or heat trauma, infection, sepsis, acute pancreatitis and rupture of an aortic aneurysm. In other words, independently of the cause, MODS is generally preceded by a situation associated with a period of cardiovascular instability and/or release of mediators (q. v.)[2] .

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  1. G. Berlot
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  2. U. Lucangelo
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  3. A. Gullo
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Editors and Affiliations

  1. Department of Surgery, Health Sciences Center, Saint Louis University, St. Louis, USA

    A. E. Baue M.D.

  2. Department of Anaesthesia, Intensive Care and Pain Therapy, Cattinara Hospital, University of Trieste, Trieste, Italy

    G. Berlot M.D.  & A. Gullo M.D.  & 

  3. Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Belgium

    J.-L. Vincent M.D.

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Berlot, G., Lucangelo, U., Gullo, A. (2000). Sepsis and Organ Dysfunction. The Challenge Continues. In: Baue, A.E., Berlot, G., Gullo, A., Vincent, JL. (eds) Sepsis and Organ Dysfunction. Springer, Milano. https://doi.org/10.1007/978-88-470-2284-3_2

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