多器官衰竭1.pptVIP

Definition Dysfunction or failure of multiple organ or system happened in acute disease process simultaneously or sequentially due to various etiological factors. Etiology Infection: Gram +/- bacteria, fungal, Virus Shock : hemorrhage, etc. Allergy Burns Trauma Severe acute pancreatitis Classification of MODS Immediate Type (Primary)： Dysfunction are happened simultaneously in two or more organs due to primary disease. Delayed type (Secondary)： Dysfunction happened in a organ, other organs sequentially happened dysfunction or failure. Accumulation type： Dysfunction leaded by chronic disease. Attention Immediate Type Not related to SIRS Coup injury with chemical or physical factors No time interval from disease ARDS+ARF or ARDS +ARF +DIC +AHF Delayed type Not the direct outcome from injury Relating to SIRS（systemic inflammatory response syndrome） Time interval existed from primary disease Diagnosis of Criteria Attention Familiar with the causes and risk factors of MODS ! Do more detailed inspection in time ! All ICU patients should be dynamic monitoring of cardiac, respiratory and renal function! When an organ dysfunction, be attention to observe the changes of other organs timely! Familiar with the diagnostic standard of MODS! Treatments of MODS 1.Combined therapy Correction of ischemia: fluid resuscitation, mechanical ventilation Prevention of infection： drainage, antibiotics Interruption of pathological reaction： hemofiltration Stabilization of internal enviroment： water, electrolyte, acid-base imbalance Regulation of immunity： 2.Support of organ function Ventilator Artificial kidney Artificial liver Protection of enteral mucosa Drugs of protection of heart Acute Renal Failure (ARF)急性肾衰竭 Definition Characterized by ineffective filtration across glomeruli in short time. Such as azotemia, i