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Describe Multiple Organ Dysfunction Syndrome (MODS)
progressive physiologic failure or 2 or more separate organ systems
homeostasis cannot be maintained without intervention - poor prognosis
What is the etiology of MODS?
organ dysfunction may be the direct consequence of an initial insult (Primary MODS) or an manifest latently and involve organs not directly affected in the initial insult (secondary MODS)
What are the risk factors for MODS?
What are the pulmonary manifestations of MODS?
-acute lung injury pattern of respiratory failure
What are the renal manifestations of MODS?
decreased GFR/creatinine clearance
increased serum creatinine and BUN
oliguria, anuria, or polyuria
What are the hyperdynamic CV manifestations of MODS?
-decreased right atrial pressure
-decreased left ventricular stroke work index
-increased O2 consumption
-increased CO, CI, HR
What are the hypodynamic CV manifestations of MODS?
-increased right atrial pressure
-increased left ventricular stroke work index
-decreased O2 consumption
-increased CO, CI
What are the GI manifestations of MODS?
abdominal distention and ascites
intolerance to enteral feedings
upper and lower GI bleeding
decreased bowel sounds
bacterial overgrowth in stool
RUQ tenderness or pain
What are the metabolic/nutritional manifestations of MODS?
decreased lean body mass
severe weight loss
negative nitrogen balance
decreased serum albumin, serum transferrin, prealbumin, retinol binding protein
increased serum lactate
What are the immune manifestations of MODS?
decreased lymph count
What are the CNS manifestations of MODS?
What are the coag/hematologic manifestations of MODS?
What are the hepatic manifestations of MODS?
increased serum bilirubin
increased liver enzymes
increased serum ammonia
decreased serum albumin
decreased serum transferrin
How is MODS managed?
-identification and treatment of infection or cause
-NUTRITIONAL AND METABOLIC SUPPORT FOR FAILING ORGANS.
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