Multiple organ failure. What is it in simple words, the causes in adults, newborns, the elderly, acute heart

When simultaneous dysfunction of multiple organs, physiological systems, there is a multi-organ failure. As it appears, the reasons for what it is, and which emit treatments need to learn before choosing a therapy.

What it is

Multiple organ failure - a disease that is a complex pathological condition person, especially due to the current dysfunction 1 or 2 in human organs (usually a child, teen). In 80% of cases, the disease causes high mortalityEspecially if we neglect the timely treatment and diagnosis.

Multiple organ failure is characterized as a base appearance of a critical indicator of physiological processes of the body. The degree of damage depends on the capabilities of the human body to resist pathogenic factors, microorganisms.

disease code ICD-10

Just 10 years ago, it has developed and adopted around the world a common classification for the coding and recognition of medical diagnoses. Medical until encoding has 21 classes, each of which category of diseases and pathological conditions. According to the international medical classification of viruses and diseases, multiple organ failure has a status - «R65.3».

clinical picture

The clinical manifestations of multiple organ failure affects nearly every system of the body. At the first signs of development of multiple organ failure activators damage generalized functional systems involve a system-wide response.

In this case exhibits the following clinical characteristics:

• The heat from the temperature of 37-38 degrees.
• Quickens the pulse of 90-95 beats per minute.
• Quickens frequency breaths more than 20 times per minute.
• Arterial hypocapnia - less than 32 mm Hg. Art.
• Leukopenia - less than 4.000 mm.
• Leukocytosis - 12000 mm.

Multiorgan failure (what it is and how it is shown - knowledge, saving a person's life) begins abruptly, the temperature rises suddenly. Depending on the strength of the body can be observed chills, vomiting, severe headaches. On the severity of symptoms affected by the fact what specific systems affected by the disease.

The following characteristics indicate after medical laboratory tests for the presence of multiple organ failure:

1. Hemostatic dysfunction, thus fibrinogen degradation over 1 \ 40, prothrombin index of less than 70%, platelets - less than 150 g \ l.
2. Acute respiratory syndrome in which there are bilateral pulmonary infiltrates.
3. Renal dysfunction in which there is more blood creatine 0.176 mmoles \ l sodium in urine is reduced to 40 mM.
4. Liver failure, in which the AST and ALT levels are increased in 2 times more than the norm.
5. CNS disorders work, diagnosed on a scale of Glasgow - less than 15 points.

Complex diagnostics allows to detect changes of the patient, as well as its independent ability to withstand disturbances in the body.

influence of infection

Multiple organ failure: what is it, what are the reasons - there is against the background of the primary infectious lesions. The primary foci of inflammation - the area of ​​the respiratory system (bronchi, lungs) and peritonitis. If the development of multiple organ failure is added to a septic infection that develops in the first 2-3 days, can begin serious health complications.

If you add an infection, the chances of recovery and life are significantly reduced, although the timely diagnosis and proper treatment, the patient can survive.

The causes of the disease in newborns

Multiple organ failure: what it is, what factors contribute to the development it is important to understand before starting therapy. Most often it occurs in conjunction with pathological changes of the functions of organs and physiological systems. It can occur after trauma, acute illnesses and state of shock, etc.

To the list of reasons that can cause a similar condition include:

• Ulcers and colitis.
• Serious life-threatening injuries.
• Severe injuries of the skin.
• Severe course of infection processes.
• A large amount of blood loss.
• Strong food or alcohol poisoning.
• A state of shock.
• Diabetic complications.
• Asistologiya.
• Eclampsia.
  
• Sepsis.
• Coma.
• HIV infection and AIDS.
• The period after chemotherapy.
• Blood discrepancy (factor group) after transfusion.

There is also a factor in the development of such problems include severe stress, severe state of man.

Multiple organ failure is brought in a number of systemic diseases. Distinguish number of etiological factors that may become catalysts.

They are:

• Alcoholic binges (perennial).
• tobacco use.
• The long period of steroids.
• The use in the treatment of cytotoxic drugs.
• Wrong diet.

Often complex disease syndrome occurs provided sharp decrease the body's defenses, after serious infectious diseases.

The development of the disease in the elderly

Among elderly patients with multiple organ failure number is several times higher. Often, such a condition occurs in conjunction with the associated disorders and diseases. This is a serious threat to human life, it requires long-term effort and maintain vital functions.

Reasons for the development of multiple organ failure in the elderly:

• Injury.
  
• A state of shock.
• Coma.
• Septic infections.

Multiorgan failure (what it is, how to treat old age determined by the physician) is characterized by long-term hospitalization and high mortality.

disease symptoms

Factors that indicate the development of multiple organ failure, may vary based on the stage of the disease, type and combination systems. In addition to the symptoms affect related disease, infection, and other factors.

Primary symptoms of multiple organ dysfunction syndrome:

• Total prostration, malaise.
• Respiratory failure.
• Increased heart rate.
• Cold and numbness in the extremities.
• Dyspnea.
• pale skin.
• Sclera become yellow.

  

• Indigestion.
• Bruising.

Most of the symptoms of multiple organ failure syndrome are similar to other diseases, so it is easy to miss. For accurate pictures and timely treatment is required to conduct additional diagnostics in the laboratory.

For example:

• Pathological disorders of the respiratory system are accompanied by difficulty breathing, shortness of breath.
• Kidney dysfunction causes changes in the characteristics of the urine sample.
• If multiple organ failure has affected the liver, blood tests will be Yarkov visible changes bilirubin, and jaundice.
• When multiple organ failure affects hemostasis, thrombocytopenia will occur and such deviations from the norm.
• If the affected heart on the background of the disease, there has been the development of hypotension appears ventricular arrhythmia, congestive heart failure.
• Gastrointestinal disorders are characterized by the appearance of the work of several foci of inflammation and perforation in the lining of the digestive tract.
• Lesions of the central nervous system characterized by the presence of acute psychoses, excitement.

Multiple organ failure - it is a disease that occurs in conjunction with the development of hemostatic dysfunction, which is caused by deficiency of blood clotting, hyperstimulation.

DIC promotes thrombotic disorders, hemorrhagic dysfunction, inhibition of blood microcirculation. Mostly in DIC syndrome develop abnormal function of certain organs: subcutaneous bruising, petechial-gematomnye rash on the body. In case of complications can occur shock, hypotension, severe bleeding.

One of the most frequent manifestations of systemic disease is acute heart failure. This is due to the fact that the muscles of the heart bags sharply reduced elasticity and contractile properties. As a result, blood circulation slows down the process, there are blood stagnation.

Without timely treatment of this syndrome can lead to swelling of the respiratory, asthmatic fits. This is an extremely serious condition, threatening the patient's life.

phase of development

Multiorgan failure (what it is and prevention measures is important to know the development of the disease) is not divided into several stages of the flow.

They are:

• Induction - is shown as the synthesis of biologically active substances in the body due to the stimulation of mediators, which cause inflammatory response start process.
• cascade - it takes the form of uncontrolled syndrome, acute lung injury, as well as the activation of the kinin-kallikrein system, arachidonic acid. In addition substantially reduced level of fibrinolysis and concomitant hemostatic systems.
• secondary autogressiya and complete loss of homeostasis. Difficult enough for phase characterized by long-term treatment, high mortality.

Classification by the form of the pathogenetic mechanism

Based on the pathogenesis mechanism for multiple organ dysfunction syndrome may be different:

1. For 1st-phase form for the syndrome characterized by the development of acute pathologies. So, for 1-2 days there is disruption of the metabolism of active substances, when added to kidney and liver failure. Dysfunction of the central nervous system organs, disruption of the cardiovascular system, hemostasis. In this case, the pathological process is preceded by the death of or serious injury.
2. The second stage of this syndrome on the background of the pathogenesis mechanism causes the development of two-phase flow of pathological processes. After the first stage the patient can feel the drastic improvement in condition, the temporal stabilization being. This occurs until the addition to the symptoms of sepsis and infection. In consequence of a septic infection develops several days, if in time to take action - the patient can recover.

What is the risk of multiple organ failure

In medicine syndrome is a response of the organism for a complex of acute pathologies. Although the primary etiology, the syndrome is accompanied by the failure of all the important functions of life support systems and human functioning. Complications of multiorgan failure may be phenomena that accompany pulmonary failure, severe kidney disease.

They are as follows:

• Dysfunction of the circulatory system.
• development of hypoxia.
  
• Anemia.
• Weakness, fainting.
• Dysfunction of the formation of proteins and immunoglobulins.
• Uncontrolled hyperglycemia form.
• Heart failure.
• Thrombocytopenia.
• Removal of a protective barrier walls of the digestive system.

Despite the complexity of the current, multi-organ failure is a curable disease. By taking an active and timely treatment, in conjunction with the resuscitation can preserve health and save lives.

prognosis

The extent and complexity of flow syndrome is determined by a specially developed for this scale MOF (Multiple Organ Failure).

In this case, estimated life-support systems oragnizma 7:

• Breathing.
• Urinary.
• Hematologic.
• Central nervous system.
• Digestive (gastrointestinal organs).
• liver organs.
• Cordial-vascular.

Forecast for the future, the recovery is built on the basis of the number and extent of damaged organs, body systems.

So statistics provide the following information:

• 1 organ system - 20% mortality.
• 2 bodies of the system - 25-30% of mortality among the elderly.
• System 3 - more than 50% of deaths.
• 4 or more of the system - 70-80% of the patients death.

Also available are the consequences of multiple organ failure, such as:

• When secondary infectious lesions - a high risk of mortality (especially in children).
• Full or partial failure of internal organs functioning.
  
• Leveling medical procedures, such as hemodialysis.

Methods of treatment

Before you assign a treatment, it is necessary to carry out laboratory tests and studies that show the extent and area of ​​effect syndrome. To do this, use basically only laboratory tests.

Multiple organ failure: diagnosis and, immediately, that this is confirmed by the formation of multiple signs of disease progression systems of functions and organs. For example, damage hemostasis and severe respiratory failure, or, for example, kidney and liver failure.

syndrome occurs in a complex therapy, including several major areas:

1. Prevention syndrome occurs by means of a timely diagnosis and limit disease development. This is the primary prevention of the syndrome, it is necessary to carry out a functional assessment of the health of the body, monitoring and elimination of infection. The hospital carried out the normalization of the circulatory system, while pathologists hemostasis has not passed the critical mark. It is also important to carry out reconstruction activities of the respiratory system, the treatment of necrosis, severe injury or damage.
2. The second principle of quality treatment is a landmark and the exact sequence of actions. The most effective therapy scheme includes artificial medical therapeutic and maintain operability of the affected system. It acts effectively substitution of defective organs. Often this relates to the organs of respiration and circulation, increased efficiency of physiological mechanisms, treatment of damaged organs, sites. Therapy to eliminate the patient's state of shock.
   
3. Antimediatornoe property, which is therapy aimed at arresting the endothelial cell receptor efficiency, their performance antagonists. To this end generally use monoclonal antibodies against TNFa IL-1.
4. Restoring normal levels of energy balance. For this purpose, the whole scheme of events: changes in the metabolism process, the creation of acid-base balance, normalization of efficiency of the enzyme system. Also prescribed food body with a special probe, the introduction of vitamins, amino acids, and artificial enrichment of oxygen to tissues. In the course of therapy include the restoration of normal lung function and blood circulation, anti-hypoxic and antioxidant drug treatment of the patient.
5. Therapy eliminate toxins and harmful effects, namely the stimulation of natural detoxification. For this purpose, intra- and extracorporeal methods in stationary conditions.
6. Syndromic therapy. To do this, the components multiple organ dysfunction syndrome in the acute form, eg, hypovolemia, problems with clotting, distress syndrome, liver acute diseases require an individual approach to all patients. treatment methods have been developed to relieve symptoms, they include drug substitution and maintenance of those or other vital organs.
7. Reducing invasive action. Complex technique, which includes the invasiveness of innovative technologies to reduce the criticality of symptoms. Otherwise, complications on the background of this syndrome can lead to iatrogenic multiple organ failure. Despite this, many doctors refuse invasive techniques, because in addition to their use in hiding the real threat to life and health of the patient.

In the second stage of recovery can assign the following treatment:

• Mechanical ventilation (if you have trouble breathing).
• The use of cardiotonic drugs.
• Purification of blood of toxins, heavy metals (droppers).
• Gemodialez.
  
• Maintaining a heart rate by artificial means.

Duration integrated treatment response depends on the complexity and number of affected organs lasts between 7 to 20 days. Equally important is the age of the patients.

Play an important role preventive measures, especially in the management of severe patients who have a high likelihood of developing this syndrome.

Preventive techniques are ideal therapeutic effects on the victims of the complex critical conditions. It is especially difficult occur such pathology on the background of this syndrome as acute forms of infectious inflammation, blood loss.

The complex of preventive measures provided for systematic diagnosis, examination, treatment of pathologic, chronic processes in the body. In addition, it is important to provide support for all functions of the organism as a whole, enriching the fabric with microelements and vitamins to prevent irreversible phenomenon and further long-term treatment.

Effectiveness of the chosen method depends on a correct evaluation of the condition and timely diagnosis amount affected systems and organs.

When the treatment is prophylactic, preventive character, the risk of death is significantly reduced and the patient's recovery is possible. Awareness of the mechanisms patofizicheskih process allows time to determine the development of multiple organ dysfunction syndrome, take well-constructed treatment policy.

Multiple organ failure: how to manifest what it is, what are the causes of development - important information for those who are predisposed to the disease. It is a group of systemic diseases in which there are malfunctions of 2 or more organs.

Such a condition is equally common in both adults and children. Especially the development of multiple organ failure in the fact that human organs and systems of the body are damaged so that they can completely fail, unable to perform the functions and tasks, to maintain vital functions person.

Registration of the article: Lozinski Oleg

Video of multiple organ failure

All of the syndrome of multiple organ failure:

The principle of hemodialysis: