[Characteristics and treatment of multiple organ dysfunction syndrome in patients with trauma in the Wenchuan earthquake on 12th May, 2008].
OBJECTIVE
To analyze the characteristics and treatment of the multiple organ dysfunction syndrome (MODS) in patients in the Wenchuan earthquake on 12th May, 2008, in order to provide theoretical reference for future care for such patients.


METHODS
Characteristics of MODS in these patients were analyzed, differences between survivors and non-survivors were compared, and therapeutic measures, and the time of the treatment for MODS in patients with earthquake related injury or illness who were admitted to West China Hospital from 12th May to 20th June, 2008, were retrospectively analyzed.


RESULTS
A total of 42 MODS patients were admitted to intensive care unit (ICU). Both the acute physiology and chronic health evaluation II (APACHE II) score and predicted death risk were lowering during the course of therapy. Fractures of bones of extremities were predominant in the earthquake related diseases, with an incidence of 45.2%. The actual mortality of MODS (33.3%) was lower than the predicted death risk (41.5%). The age, the time of receiving the first treatment in ICU after the earthquake, the Glasgow score, the oxygen index, blood creatinine level, platelet count, and vasoactive agent pumping velocity were significantly different between survivors and non-survivors (all P<0.05). The overall mortality was 9.8%, the morbidity of cardiac dysfunction, the incidence of acute renal failure (ARF) and sepsis were significantly different between non-survivors and survivors (all P<0.05). The use of mechanical ventilation, continuous renal replacement therapy (CRRT), and vasoactive agent reached peak level on the 14-29 days after the earthquake.


CONCLUSIONS
Fracture of bones of extremities are predominant injury in the earthquake related diseases, and the cause of death is closely associated with multiple trauma and ARF, systemic infection of large wound surfaces. The central nervous system, respiratory system, circulatory system, renal function, circulatory system should be monitored during the treatment. Adequate preparedness is essential in order to cope with the peak period of occurrence of serious complications after a disaster.
Pu
Hong
H
Intensive Care Unit, West China Hospital, Si chuan University, Chengdu 610041, Sichuan, China.
Jin
Xiao-dong
XD
Deng
Yi-yun
YY
Kang
Yan
Y
Xie
Xiao-qi
XQ
Liao
Xue-lian
XL
Yang
Ling
L
Wang
Lan
L
Wang
Cun-zhen
CZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D014947:Wounds and Injuries / Q000150:complications