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Understanding Multiple Organ Dysfunction Syndrome

MODS, also known as multiple organ failure or dysfunction, is defined as the development of potentially reversible physiological derangement involving two or more organ systems not involved in the initial condition requiring ICU admission, occurring after a life-threatening physiological insult. A scoring system is used to assess organ dysfunction in six systems - respiratory, renal, hepatic, cardiovascular, hematological, and neurological. The prognosis worsens with the number of failing organ systems, with mortality rates ranging from less than 10% for one failing system to over 80% for five or more failing systems.

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Sammy Oh
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13 views15 pages

Understanding Multiple Organ Dysfunction Syndrome

MODS, also known as multiple organ failure or dysfunction, is defined as the development of potentially reversible physiological derangement involving two or more organ systems not involved in the initial condition requiring ICU admission, occurring after a life-threatening physiological insult. A scoring system is used to assess organ dysfunction in six systems - respiratory, renal, hepatic, cardiovascular, hematological, and neurological. The prognosis worsens with the number of failing organ systems, with mortality rates ranging from less than 10% for one failing system to over 80% for five or more failing systems.

Uploaded by

Sammy Oh
Copyright
© All Rights Reserved
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MULTIPLE ORGAN

DYSFUNCTION
SYNDROME
(MODS)
Other Names:
Multiple Organ Failure
Multiple Systems Organ Failure
Multi-organ Failure

Other manifestations
ARDS
DIC
The Multiple Organ Dysfunction Syndrome
(MODS) can be defined as the development of
potentially reversible physiologic
derangement involving TWO OR MORE organ
systems NOT involved in the disorder that
resulted in ICU admission, and arising in the
wake of a potentially life-threatening
physiologic insult.
MULTIPLE ORGAN DYSFUNCTION SCORE
Organ system 0 1 2 3 4
Respiratorya(PO2/FIO2 Ratio) > 300 226–300 151–225 76–150 ≤ 75
Renalb(Serum Creatinine) ≤ 100 101–200 201–350 351–500 > 500
Hepaticc(Serum Bilirubin) ≤ 20 21–60 61–120 121–240 > 240
Cardiovasculard(R/P Ratio) ≤ 10 10.1–15 15.1–20 20.1–30 > 30
Hematologice(Platelet count) > 120 81–120 51–80 21–50 ≤ 20
Neurologicf(Glasgow Coma Score)15 13–14 10–12 7–9 ≤6
 The PO2/FIO2 ratio is calculated without reference to the use
or mode of mechanical ventilation, and without reference to
the use or level of PEEP.
 The serum creatinine level is measured in μmol/liter,
without reference to the use of dialysis.
 The serum bilirubin level is measured in μmol/liter.
 The R/P ratio is calculated as the product of the heart rate
and right atrial (central venous) pressure, divided by the
mean arterial pressure:
 The platelet count is measured in platelets/mL 10-3
 The Glasgow Coma Score is preferably calculated by the
patient's nurse, and is scored conservatively (for the patient
receiving sedation or muscle relaxants, normal function is
assumed unless there is evidence of intrinsically altered
mentation).
PROGNOSIS OF MLTIPLE ORGAN FAILURE
Number of failing systems Mortality (%)
0 < 10
1 0–30
2 20–50
3 40–80
4 60–100
5 or more > 80

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