[Critical care for organ failure].
We retrospectively studied the critical care regimen for multiple organ failure (MOF) in 141 surgical MOF patients treated in the intensive care unit of Chiba University Hospital between January 1988 and April 1998. Patients with gut failure received parenteral instead of enteral nutrition for various reasons such as concomitant ileus. Of the patients with respiratory failure. 138 were placed on a ventilator and 6 received percutaneous cardiopulmonary support. Continuous hemodiafiltration (CHDF) was performed in 98 patients with renal failure. Plasma exchange was carried out in 13 patients with liver failure. Of these patients, 62 (44%) survived. Colloid osmotic pressure was used as an indicator for fluid therapy. For prophylaxis against bacterial translocation, we performed selective digestive decontamination. Recently blood purification methods, particularly CHDF, have become common in the critical care setting. CHDF is efficacious not only as continuous renal replacement therapy but also as a humoral mediator modulator and is currently the first-choice method for blood purification in critical care. In conclusion, there have been many advances in the critical care of patients with organ failure. Multidisciplinary treatment, including artificial support for failing organs, is necessary for the survival of these patients.
Shiga
H
H
Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, Japan.
Hirasawa
H
H
D002315:Cardiopulmonary Bypass; D003422:Critical Care; D004750:Enteral Nutrition; D006440:Hemofiltration; D006801:Humans; D007263:Infusions, Parenteral; D009102:Multiple Organ Failure / Q000628:therapy*; D010951:Plasma Exchange; D012122:Ventilators, Mechanical