[Polytrauma and multi-organ failure syndrome. Definition--pathophysiology--therapy].
The multiple organ dysfunction syndrome (MODS) with a mortality of 50% to 70% represents the number 1 cause of death in surgical intensive care units. It is divided in a primary and a secondary MODS based on time of manifestation and pathophysiological events which attribute to it. The therapy of the primary MODS includes sufficient and quick resuscitation, adequate oxygen delivery and early enteral nutrition to reduce or avoid the incidence of bacterial translocation. In addition, a reduction of the antigenic load by control of hemorrhage, radical wound debridement, decompression, and fixation of long bone fractures appears to be effective in reducing the occurrence of MODS. The treatment of the secondary MODS remains supportive and its prevention is essential. Further studies have to be carried out to evaluate the clinical significance of new therapeutical agents such as monoclonal antibodies or cytokine receptor antagonists.
Ertel
W
W
Klinik für Unfallchirurgie, Universitätspital Zürich.
Trentz
O
O
D000209:Acute-Phase Proteins / Q000502:physiology; D002423:Cause of Death; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D009102:Multiple Organ Failure / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D009104:Multiple Trauma / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy
D000209:Acute-Phase Proteins