Multi-Organ Dysfunction Syndrome Flashcards Preview

Year 5 Acute Care & Trauma > Multi-Organ Dysfunction Syndrome > Flashcards

Flashcards in Multi-Organ Dysfunction Syndrome Deck (33)
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1
Q

def

A

a syndrome of progressive organ failure affecting one organ after another

2
Q

what are causes of MODS

A
2Is and 2Hs
Infection
Injury
Hypoperfusion
Hypermetabolism
3
Q

what is MODS also known as

A

multiple organ failure

4
Q

aetiology

A

causes (2Is and 2Hs) trigger an inflammatory response

5
Q

what is the progession to MODS

A

SIRS -> (+infection) -> sepsis -> septic shock -> MODS

6
Q

what is the most common cause of MODS

A

sepsis (SIRS + infection)

7
Q

what organs are progessively involved in MODS

A

respiratory failure (first)
Liver failure
GI bleeding
Kidney failure (last)

8
Q

what are the four clinical phases of MODS score

A

stage 1
stage 2
stage 3
stage 4

9
Q

what are features of stage 1 MODS score

A
respiratory failure (mild respiratory alkalosis)
hyperglycaemia and increased insulin requirements
10
Q

what are features of stage 2 MODS score

A
respiratory failure (tachypnoea with low CO2 and low O2)
liver failure
11
Q

what are features of stage 3 MODS score

A

kidney failure (azotaemia and acid-base disturbances)

12
Q

what are features of stage 4 MODS score

A
requires vasopressers to maintain BP
kidney failure (oliguric or anuric)
13
Q

what is the sepsis six

A

six things to be done within one hour of diagnosis of sepsis to reduce mortality

3 IN
-oxygen
-empiral IV antiboitics
-IV fluids
3 OUT
-blood cultures
-lactate and FBC
-urine output
14
Q

what is sepsis

A

life-threatening organ dysfunction caused by SIRS and infection

15
Q

what is SIRS

A

systemic inflammatory response syndrome which ca result from infection, or non-infectious causes such as trauma or burns or pancreatitis)

16
Q

what are the criteria for SIRS

A

any 2 of:

temp >38 or <36
HR >90bpm
>20RR or PaCO2 <4.3 (32mmHg)
WCC >12000/mm3 or <4000/mm3 or >10% immature

17
Q

what is the criteria for sepsis

A

SIRS + infection

temp >38 or <36
HR >90bpm
>20RR or PaCO2 <4.3 (32mmHg)
WCC >12000/mm3 or <4000/mm3 or >10% immature
hyperglycaemia (>7.7) in the absence of DM
altered mental state

18
Q

what is the criteria for severe sepsis

A

sepsis +

lactic acidosis
SBP <90 or drop of >40mmHg

19
Q

what is the criteria for septic shock

A

severe sepsis with hypotension despite fluid resuscitation

20
Q

what are features of MODS

A

evidence of >2 organs failing

21
Q

epi

A

common in elderly

22
Q

what are common causes of infection

A

bacteria most commonly

23
Q

what is the most common cause of infection in sepsis

A

e coli

24
Q

what group of bacteria causes most sepsis

A
gram positive (s aureus, enterococci and streptococci) cause more sepsis combined than gram negative (e coli, klebsiella, pseudomonas)
however e coli is most common cause!!!
25
Q

what is the most common fungal cause of sepsis

A

candida

26
Q

what are risk factors for sepsis

A

elderly
malignancy or immunocompromised
any source of infection into the patient (haemodialysis, catheters, recent surgery)

27
Q

what are features of sepsis

A

temp >38 or <36
tachycardiac
tachypnoea + low SATs
hypotension

signs associated with infection

28
Q

what is purpura fulminans

A

widespread bleeding due to organ dysfunction

29
Q

what causes purpura fulminans

A

pneumococcal septicaemia

30
Q

how is sepsis diagnosed

A

clinical criteria for SIRS plus infection

31
Q

what is the first thing that should be done when assessing sepsis

A

ABCDE and DEFG

32
Q

what are the initial investigations for sepsis

A

1 identify causative organisms (blood cultures)
2 evaluate organ dysfunction (bloods - ABG, LFTs, FBC, coagulation, creatinine and urea and electrolytes + glucose)
3 identify source of infection (CXR)
4 to determine prognosis (lactate)

33
Q

what marker is used for prognosis

A

lactate