多器官功能不全综合症 英语.pptVIP

multiple organ Dysfunction Syndrome mods Definiti Dysfunction or failure of multiple organ or system happened simultaneously or sequentially due to various etiological factors 已ibs Infection: Gram positive/negative bacteria, fungal, Virus 7 Shock hemorrhage,etc Allergy y Burns Trauma Severe acute pancreatitis Classification of Mods Immediate Type(Primary): Dysfunction are happened simultaneouslyin 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 mmediate Type Delayed type Accumulation type Not related to y Not the direct Accumulation outcome from iRreversible Coup injury wit Relating to sIrs ysical factors No time interval existed from from disease primary disease ARDS+ARF or ARDS+ARF+DI C+LF Mechanism Inflammatory mediators priming sirs leading to mOds Vascular permeability t+ PMn chemotaxis adhensive PMN molecules C Mono /Macrophage elastase PLA2 oxygen free radica ≤ Endotheliun PAF DIC Tissue injury Remote organ injury acute phase PMN ommon Manifestations of MODS Or rgan Symptoms Heart Acute heart failure Peripheral circulation Shock Lu ALI /ARDS Kidney ARF Gastro-intestine Stress ulcer/ enteroparalysis Liver Acute hepatic failure brain CNS failure Coagulation DIC Diagnosis of criteria Organ/ system dysfunction and failure Organ or Dysfunction Function Failure systems Hypoxia, ventilator support at ARDS, PEEP10cmH,O, and FiO≥0.5 Liver Bile≥2-3mgdL Bilirubin 8-10mg/dL And AST/ALTdouble normal Jaundice Kidney Oliguria hemodialysis Or Cr 2-3mg/dL Intestine Intolerance of enteral nutrition at Blood infusion due to stress ulcer least 5 days Severe enteroparalysis Blood PT or APTT prolonged; PLT5. DIC 10,/L or hypercoagulation Insanity: mild disorientation Progressive coma Cardia- EF decreased or Cls No response to inotropic agent Deitch EA. Ann Surg 1992: 216(2): 117-134