Presentation on theme: "Pathophysiology Multiple Organ Dysfunction Syndrome Pathophysiology Department, Tongji Medical College, HUST."— Presentation transcript:
Pathophysiology Multiple Organ Dysfunction Syndrome Pathophysiology Department, Tongji Medical College, HUST
World War One Circulatory failure, hypovolemic shock World War Two Korean War Post-traumatic acute renal insufficiency Viet Nam War Post-traumatic acute respiratory insufficiency Seventy’s 70’s syndrome 1991 Multiple organ dysfunction syndrome
Left leg open trauma Day 2: Shortness of breath, Oliguria Day 4: ↑ T 39.5 ℃ ↑WBC (18×10 9 /L) ↑ R 35 /m, cyanosis, PaO 2 <60mmHg Urine <100ml/d Creatinine ↑↑ BUN ↑↑ Renal failure Respiratory failure Day 6: Death Case report
Pathophysiology Multiple Organ Dysfunction Syndrome (MODS) is dysfunction of two or more organs (initially uninvolved developing within a short period of time. short period two or more organs initially Definition uninvolved Cor pulmonale?
Multiple system organ failure. The role of uncontrolled infection. They studied multiple parameters in 553 consecutive emergency surgical patients. MSOF is primarily due to infection. MSOF is the most common fatal expression of uncontrolled infection. 1980,115(2):136-140. Causes
Pathophysiology Why did anti-biotic strategies fail in some of the patients with MODS? Why did anti-biotic strategies fail in some of the patients with MODS?
Pathophysiology Bacterial translocation The viable bacili locomote from the gastrointestinal tract to the other organs.
Pathophysiology Intestinal flora imbalance Immune dysfunction Intestinal mucosal ischemia Causes for the translocation
Pathophysiology What exactly is "leaky gut" or "increased intestinal permeability"? To understand the importance of increased intestinal permeability, you must first understand the basic concepts that: 1) the intestines are supposed to absorb nutrients, and 2) the intestines are supposed to exclude (not absorb) potentially harmful substances like bacteria, toxins, food proteins (which cause food allergy). Therefore, when we talk about "leaky gut" and "increased intestinal permeability" we are describing a condition where in these basic functions are failing. The intestines are failing in the ability to absorb nutrients, and the intestines are absorbing too many toxins.