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Multiple Organ Dysfunction Syndrome (Primary MODS (Local / mild systemic…
Multiple Organ Dysfunction Syndrome
Primary MODS
Organ dysfunction occurs early and
is DIRECTLY attributable to the insult
Activation of resident macrophages and neutrophils
Local / mild systemic inflammatory response
2 or more of...
Temperature > 38
Heart rate > 90
Respiratory rate > 20
Hyperventilation with PaCO2 < 32mmHg
WCC > 12 x 10(9)
10% immature forms
Primes the physiologic system for a more sustained exaggerated inflammatory reponse that leads to...
Secondary insult
Secondary MODS
Activation of Coagulation Cascade
Microvascular clotting
Impaired microvascular circulation
Activation of Kinin
Vasodilation
Activation of Complement Cascade
Neutrophil adherence and activation
Recruitment of additional WCCs
(leading to increase in immature forms)
Activation of Fibrinolytic Cascade
Macrophage activation
GI microcirculation failure
Gut barrier failure = leaky gut syndrome
1 more item...
Uncontrolled Systemic Stress Response
Selective Vasoconstriction
Vasodilation
Increased Capillary Permeability
Endothelial Damage
Maldistribution of blood flow
Interstitial oedema
Impaired tissue perfusion
1 more item...
Hypermetabolism
Hyperdynamic Circulation
Increased oxygen and nutrient demand
Oxygen supply / demand imbalance
2 more items...
Endothelial dysfunction
Neuroendocrine response
Well defined initial organ injury / insult