A New Scoring System For Evaluation of Multiple Organ Dysfunction Syndrome in Premature Infants

2012 ◽  
Vol 21 (5) ◽  
pp. 328-337 ◽  
Author(s):  
Merih Çetinkaya ◽  
Nilgün Köksal ◽  
Hilal Özkan
Keyword(s):  
Organ Dysfunction ◽  
Premature Infants ◽  
Multiple Organ Dysfunction Syndrome ◽  
Respiratory System ◽  
Scoring System ◽  
Multiple Organ ◽  
Gastrointestinal System ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
The Mean

Background The Neonatal Multiple Organ Dysfunction (NEO-MOD) scoring system is used to predict mortality in infants with multiple organ dysfunction syndrome (MODS). The NEOMOD scoring system was extended to include involvement of the microvascular system. This modified scoring system was developed to enable more accurate and earlier diagnosis of MODS in premature infants. Objective To evaluate the modified NEOMOD scoring system in preterm infants with MODS and compare its effectiveness with the NEOMOD scoring system. Methods This prospective study was performed in a tertiary neonatal intensive care unit. A total of 198 premature infants were enrolled. Infants were evaluated for development of MODS by using the modified NEOMOD scoring system until discharge or death according to clinical and laboratory findings. Infants who had organ dysfunction in 2 or more organ systems had MODS diagnosed. Results In the 160 infants (80.8%) with MODS, the gastrointestinal system, respiratory system, and hematologic system were involved most often. The gastrointestinal system, respiratory system, and acid-base metabolism were involved initially in 99.4%, 86.3%, and 26.3% of infants, respectively. The mean modified NEOMOD score for the infants who died in the first 28 days after birth was significantly higher than the mean score for infants who survived. The number of systems involved was also higher in infants who died. Conclusions The modified NEOMOD scoring system is a safe and accurate tool for determining both mortality rate and dysfunction of multiple organ systems affecting mortality in pre-term infants.

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

CHARACTERIZATION OF MULTIPLE ORGAN DYSFUNCTION SYNDROME IN VERY LOW BIRTHWEIGHT INFANTS: A NEW SEQUENTIAL SCORING SYSTEM

Shock ◽  
2001 ◽  
Vol 15 (5) ◽  
pp. 348-352 ◽  
Author(s):  
Jan Janota ◽  
Zbyněk Straňák ◽  
Barbora Statečá ◽  
Alena Dohnalová ◽  
Antonín Šípek ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Scoring System ◽  
Low Birthweight ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Very Low Birthweight ◽  
Very Low Birthweight Infants

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

scholarly journals A Retrospective Research of the Characteristic of Hypertriglyceridemic Pancreatitis in Beijing, China

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Wei-Ping Tai ◽  
Xiang-Chun Lin ◽  
Hong Liu ◽  
Cang-Hai Wang ◽  
Jing Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Biliary Pancreatitis ◽  
Multiple Organ Dysfunction ◽  
Gi Bleeding ◽  
Significant Difference ◽  
The Mean ◽  
Beijing China

Aim. To investigate the characteristic of hypertriglyceridemic- (HTG-) induced pancreatitis (HTG pancreatitis).Methods. We reviewed 126 cases of HTG pancreatitis and 168 cases of biliary pancreatitis as control.Results. The HTG group mean age was younger than biliary group. The number of females was a little higher than males in both groups. There were 18 cases that were recurrent in HTG group and 11 in billiary group. The mean hospitalization times were 13.7 ± 2.6 and 11.2 ± 2.3 days in two groups. Six patients received apheresis in HTG group. The proportion of severe AP was 31.0% and 26.2%, mortality 1.6% and 1.2%, comorbidity of diabetes mellitus (DM) 20.6% and 6.5% in two groups. The number of complications of gastrointestinal (GI) bleeding, sepsis, and multiple organ dysfunction syndrome (MODS) in HTG group and biliary group was 1, 1, and 2 versus 4, 12, and 4.Conclusions. The proportion of recurrent and severe AP and comorbidity of DM of HTG group was higher than billiary group. The proportion of the complications of GI bleeding, sepsis, and MODS of HTG group was less than biliary group. Apheresis could effectively reduce serum TG levels soon. There was no significant difference of the mortality between two groups.

scholarly journals Penggunaan Shock Index sebagai Prediktor MODS pada Pasien Multi-trauma di RSUP Prof. Dr. R. D. Kandou Manado

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Yan Senjaya ◽  
Ishak Lahunduitan ◽  
Djony Tjandra
Keyword(s):  
Organ Dysfunction ◽  
Sensitivity And Specificity ◽  
Multiple Organ Dysfunction Syndrome ◽  
Area Under Curve ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Shock Index ◽  
Cross Sectional ◽  
Severity Of Injury ◽  
The Mean

Abstract: Multiple organ dysfunction syndrome (MODS) is the leading cause of mortality in patients that still survive in several hours post trauma. Shock index (SI) has been proved to be useful in the early diagnosis of acute hypovolemia in normal blood pressure and pulse condition. It is used to determine the severity of injury and poor outcome in traumatic patient. This study was aimed to obtain the cut-off point ratio of SI which can be used to predict the occurence of MODS and to determine the sensitivity and specificity of SI as a predictor of MODS in multitrauma patients at Prof. Dr. R. D. Kandou Hospital Manado. This was a diagnostic test study with a cross sectional design conducted from Febuary 2016 to May 2017. Population and samples were all multitrauma patients during that period of time that met the inclusion criteria. Data were analyzed by using cut-off point analysis to obtain the area under curve (AUC), as well as the sensitivity and specificity of SI to MODS. There were 150 multitrauma patients in this study, most were males, with the mean age of 33.99 years. The mean ISS was 28.4, SIRS as many as 68.66%, and the mean shock class was 1.4. There were 63 patients with MODS, 37 patients needed PRC transfusion, and 16 patients died. The AUC 80.5% (95% CI 73.0-88.0%; P = 0.000); SI 0.950588 with the sensitivity 74.6% and specificity 78.2% to MODS. The AUC 74.1% (95% CI 61.1-87.2%; P = 0.002); SI 0.97559 with 75.0% sensitivity and 64.2% spesificity to death. Conclusion: Shock index can be used as a predictor of the occurence of MODS and death in multi-trauma patients.Keywords: SI, MODS, multitraumaAbstrak: Multiple organ dysfunction syndrome (MODS) merupakan penyebab utama mortalitas pada pasien yang selamat dalam beberapa jam setelah trauma. Shock index (SI) bermanfaat untuk mendiagnosis awal hipovolemia akut pada keadaan tekanan darah dan nadi yang normal dan digunakan sebagai penanda keparahan suatu cedera dan keluaran yang buruk untuk pasien trauma. Penelitian ini bertujuan untuk mendapatkan cut off point ratio SI yang dapat digunakan sebagai pedoman untuk memrediksi terjadinya MODS dan menentukan sensitivitas dan spesifitas SI sebagai prediktor MODS pada pasien multitrauma di IRDB RSUP Prof. Dr. R. D. Kandou, Manado. Jenis penelitian ialah uji diagnostik dengan desain potong lintang yang dilakukan mulai bulan Febuari 2016 sampai Mei 2017. Populasi dan sampel ialah semua pasien multitrauma yang memenuhi kriteria inklusi. Analisis data menggunakan analisis cut-off point serta mencari area under curve (AUC), sensitivitas, dan spesifitas instrumen SI terhadap MODS. Terdapat 150 pasien multitrauma dalam studi ini, sebagian besar berjenis kelamin laki-laki dengan rerata usia 33,99 tahun. Rerata ISS 28,4, SIRS sebanyak 68,66%, dan rerata syok kelas 1.4. Terdapat 63 pasien multitrauma mengalami MODS, 37 pasien memerlukan transfusi PRC, dan 16 pasien meninggal. Nilai AUC 80,5% (95% interval kepercayaan [IK] 73,0-88,0%; P = 0,000); SI 0,950588 dengan sensitivitas 74,6% dan spesifisitas 78,2% terhadap MODS. Nilai AUC 74,1% (95% interval kepercayaan [IK] 61,1-87,2%; p = 0,002); SI 0,97559 memiliki sensitivitas 75,0% dan spesifisitas 64,2% terhadap terjadinya kematian. Simpulan: Shock index dapat digunakan sebagai prediktor terjadinya MODS dan kematian pada pasien dengan multitrauma.Kata kunci: SI, MODS, multitrauma

scholarly journals Refining the Pediatric Multiple Organ Dysfunction Syndrome

PEDIATRICS ◽  
2022 ◽  
Vol 149 (Supplement_1) ◽  
pp. S13-S22
Author(s):  
Scott L. Weiss ◽  
Joseph A. Carcillo ◽  
Francis Leclerc ◽  
Stephane Leteurtre ◽  
Luregn J. Schlapbach ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Time Course ◽  
Research Priorities ◽  
Multiple Organ ◽  
Common Mechanism ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Organ Specific ◽  
Pathologic State

Since its introduction into the medical literature in the 1970s, the term multiple organ dysfunction syndrome (or some variant) has been applied broadly to any patient with >1 concurrent organ dysfunction. However, the epidemiology, mechanisms, time course, and outcomes among children with multiple organ dysfunction vary substantially. We posit that the term pediatric multiple organ dysfunction syndrome (or MODS) should be reserved for patients with a systemic pathologic state resulting from a common mechanism (or mechanisms) that affects numerous organ systems simultaneously. In contrast, children in whom organ injuries are attributable to distinct mechanisms should be considered to have additive organ system dysfunctions but not the syndrome of MODS. Although such differentiation may not always be possible with current scientific knowledge, we make the case for how attempts to differentiate multiple organ dysfunction from other states of additive organ dysfunctions can help to evolve clinical and research priorities in diagnosis, monitoring, and therapy from largely organ-specific to more holistic strategies.

scholarly journals Comparison of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation II and IV (APACHE) Scoring System Validity as Mortality Predictors in ICU Patients with Multiple Organ Dysfunction Syndrome in Sepsis

2021 ◽  
Vol 8 (16) ◽  
pp. 1058-1063
Author(s):  
Akshay Hiryur Manjunatha Swamy ◽  
Girish Bandigowdanahalli Kumararadhya ◽  
Srinivas Hebbal Thammaiah ◽  
Nanda Karikere Siddagangaiah ◽  
Shiva Kumar K.G
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Sofa Score ◽  
Multiple Organ ◽  
Apache Ii ◽  
Multiple Organ Dysfunction ◽  
Icu Patients ◽  
Significant Difference ◽  
The Mean ◽  
Apache Iv

BACKGROUND Multiple organ dysfunction syndrome (MODS) has recently been considered as a defining syndrome of sepsis and is responsible for a high mortality rate among the patients in the intensive care units (ICUs). Prognostication of the ICU patients is an integral part of the management of the critically ill patients and many scoring systems, for that matter, have been devised and compared for their efficiency at predicting mortality. This study was conducted to evaluate and compare the validity of sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE II) and APACHE IV as mortality predictors in intensive care unit (ICU) patients suffering from MODS in sepsis. METHODS Hundred patients diagnosed with MODS in sepsis were carefully examined, followed by relevant laboratory investigations. The SOFA score was calculated daily, and the APACHE II and IV scores were calculated on the day of admission. The scores were further compared among the survivors and the non-survivors, followed by receiver operating characteristic (ROC) curve analysis of the SOFA D1, D2, and D3 and the APACHE II and IV scores to estimate their capability of mortality prediction. RESULTS The means of the APACHE II, IV and SOFA D1 were 16.57 ± 6.49, 71.91 ± 16.19 and 8.75 ± 2.20, respectively. There was a statistically significant difference in the mean APACHE II scores (14.23 ± 5.20 vs. 21.12 ± 6.38) and the mean APACHE IV scores (67.27 ± 13.21 vs. 80.91 ± 17.77) in the survivors and the nonsurvivors. A statistically significant difference was also evident in the mean ages of the survivors and the non-survivors (52.82 ± 14.67 years vs. 63.25 ± 16.98 years). The SOFA score was high among the non-survivors than the survivors right from day-1 (10.24 ± 2.08 vs. 7.98 ± 1.86) to day-20 (15.00 ± 0.00 vs. 3.14 ± 0.38). Furthermore, ROC analysis showed that the best discrimination was provided by SOFA D3 followed by the APACHE II and SOFA D1 scores, with APACHE IV score showing the least. CONCLUSIONS SOFA score on day 3 provides the best mortality prediction in patients with MODS in sepsis, as compared to APACHE II and IV scores. KEYWORDS SOFA, APACHE II, APACHE IV, Multiple Organ Dysfunction Syndrome, Sepsis

scholarly journals Intraabdominalinė hipertenzija ir pilvo suspaudimo sindromas: diagnostika, įtaka organų veiklai ir gydymas

2014 ◽  
Vol 13 (1) ◽  
pp. 7-18
Author(s):  
Mindaugas Šerpytis ◽  
Jurij Šabliauskas ◽  
Nadežda Ščupakova ◽  
Jūratė Šipylaitė ◽  
Kęstutis Strupas
Keyword(s):  
Compartment Syndrome ◽  
Organ Dysfunction ◽  
Abdominal Compartment Syndrome ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Abdominal Pressure ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Dauginis organų nepakankamumo sindromas yra viena iš pagrindinių reanimacijos ir intensyviosios terapijos skyrių ligonių mirties priežasčių. Didėjant pažeistų organų sistemų skaičiui didėja ir mirštamumas. Nors pasiekta didelė pažanga gydant dauginį organų nepakankamumo sindromą (šiuolaikiniai dirbtinės plaučių ventiliacijos režimai, inkstų, kepenų pakaitinės terapijos metodai, ekstrakorporinė membraninė oksigenacija ir kiti gydymo būdai), tačiau ligonių, turinčių daugiau nei keturių organų nepakankamumą, mirštamumas viršija 70 % Todėl tikslinga daugiau dėmesio skirti organų nepakankamumo prevencijai ir ankstyvam kritinės būklės atpažinimui. Žalingas padidėjusio intraabdominalinio spaudimo poveikis visoms organų sistemoms yra įrodytas tiek eksperimentiniais tyrimais su gyvūnais, tiek klinikiniais tyrimais. Intraabdominalinė hipertenzija atlieka svarbų vaidmenį dauginio organų disfunkcijos sindromo patogenezėje, todėl intaabdominalinio spaudimo matavimas tapo rutininiu sunkios būklės ligonių stebėsenos rodikliu. Šioje apžvalgoje, remiantis naujausios literatūros duomenimis, apibendrinami intraabdominalinės hipertenzijos ir pilvo suspaudimo sindromo apibrėžimai, etiologija ir rizikos veiksniai, taip pat įvairūs intraabdominalinio spaudimo matavimo metodai, aptariamas intraabdominalinės hipertenzijos poveikis organų funkcijoms ir šiuolaikinės jos gydymo tendencijos.Reikšminiai žodžiai: intraabdominalinė hipertenzija, intraabdominalinis spaudimas, pilvo suspaudimo sindromas, dauginis organų disfunkcijos sindromas, dekompresinė laparotomija.Intra-abdominal hypertension and the abdominal compartment syndrome: diagnostics, effects on organ function and management The multiple organ dysfunction syndrome is one of the main causes of death in intensive care units. The more organ systems are injured the higher are mortality rates. Although there has been a significant progress in treating the multiple organ dysfunction syndrome (modern modes of mechanical lung ventilation, kidney, liver replacement therapy, extracorporeal membrane oxygenation and other techniques), the mortality rate in patients with more than four organ failures exceeds 70%. Therefore, it is reasonable to pay more attention to the prevention and early recognition of a critical illness. When the measurement of intra-abdominal pressure gradually became available in day-to-day practice, an increasing number of experimental animal testing and clinical trials have proved detrimental effects of the elevated intra-abdominal pressure on all organ systems and its role in the pathogenesis of the multiple organ dysfunction syndrome. In this review, we summarize the current literature data concerning the definitions, etiology and risk factors of intra-abdominal hypertension and the abdominal compartment syndrome as well as different techniques to measure the intra-abdominal pressure. We also discuss the pathophysiological implications of intra-abdominal hypertension on organ function and current treatment trends.Key words: intra-abdominal hypertension, intra-abdominal pressure, abdominal compartment syndrome, multiple organ dysfunction syndrome, decompressive laparotomy

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