Multiple Organ Dysfunction Syndrome

Multiple Organ Dysfunction Syndrome



Basic Information image



Definition


Multiple organ dysfunction syndrome (MODS) typically occurs because of unchecked systemic inflammation as seen in the systemic inflammatory response syndrome (SIRS) or sepsis.



Epidemiology



Species, Age, Sex


Any age or breed may be at risk for MODS because of trauma, infection, or inflammation that remains untreated or unresolved.



Clinical Presentation



History, Chief Complaint


Horses with a history of critical illness or traumatic injury with a systemic inflammatory response are at risk for the development of MODS.



Physical Exam Findings


Physical examination findings are variable and specific to the organ system involved but may include:



• Depression, lethargy


• Injected mucous membranes, increased capillary refill time


• Tachycardia or bradycardia, poor pulse quality, cool extremities


• Tachypnea


• Decreased borborygmi, decreased fecal output, colic


• Fever or hypothermia



Etiology and Pathophysiology




• Primary MODS is organ dysfunction caused by an initial disease or infectious process resulting in injury to an organ system.


• Secondary MODS is organ dysfunction caused by the systemic inflammatory response syndrome or sepsis (see “Systemic Inflammatory Response Syndrome” in this section).


• Organ systems commonly affected include:


image Central nervous system

image Respiratory system

image Renal or urinary system

image Cardiovascular system

image Coagulation system

image Gastrointestinal system

image Musculoskeletal system

image Hepatobiliary system


Diagnosis image



Differential Diagnosis


Insult or injury to an organ system caused by infection or inflammation may occur without organ failure, which indicates sepsis or SIRS but not MODS.



Initial Database




• Packed cell volume


• Total protein


• Complete blood count and differential


• Serum chemistry


• Blood lactate


• Blood pressure


• Blood gas


• Coagulation profile


• Urinalysis



Advanced or Confirmatory Testing


Relates to the specific system involved:



• Central nervous system: Neurologic exam, cerebrospinal fluid analysis


• Respiratory: Thoracic ultrasonography, radiography, transtracheal wash


• Renal: Analysis of fractional excretion of electrolytes, renal biopsy, cystoscopy


• Cardiovascular: Echocardiography, cardiac output monitoring, electrocardiography


• Coagulation system: Additional coagulation tests (d-dimer, protein C, thromboelastography)


• Gastrointestinal: Glucose absorption testing, fecal cultures, fecal egg count, biopsy


• Musculoskeletal: Pedal venogram

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Multiple Organ Dysfunction Syndrome

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