scholarly journals MULTIPLE ORGAN DYSFUNCTION SYNDROME IN ACUTE NECROTIZING PANCREATITIS

2021 ◽  
Vol 29 (5) ◽  
pp. 598-606
Author(s):  
K.V. Nikitsina ◽  
◽  
G.V. Ilukevich ◽  
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Intensive Therapy ◽  
Necrotizing Pancreatitis ◽  
Multiple Organ ◽  
Acute Necrotizing Pancreatitis ◽  
Intestinal Barrier Function ◽  
Multiple Organ Dysfunction ◽  
Abdominal Hypertension ◽  
Acute Necrotizing

Acute necrotizing pancreatitis (ANP) is associated with significantlyhighermorbidity and mortality. It is still difficult for the surgeon to choose and schedule the most appropriate treatment.In the early phase of the disease, surgical activity is considered to be ineffective and is associated with high risks. The only chance to save the patient is to conduct the intensive therapy in the intensive care unit, based on current pathogenetic approaches. The present review analyzed the current understanding of the pathogenesis of multiple organ dysfunction syndrome (MODS) in acute necrotizing pancreatitis. The role of inflammatory mediators, cytokines, biogenic amines, bradykinins, and lipid peroxidation products in the development of organ hypoperfusion is reflected. It is shown that the violation of the intestinal barrier function with the translocation of microorganisms exacerbates endogenous intoxication and contributes to the development of MODS. The endothelial dysfunction that develops in acute necrotizing pancreatitis has a significant effect on hemostasis. The literature analysis revealed the contradictory data on the functional activity of the coagulation and anticoagulation systems at different stages of the disease. The mechanisms of development of intra-abdominal hypertension and its multisystem negative impact are reflected. There are still controversialquestionof appropriatetiming and indications for surgical decompression. The analysis of the available literature data showed the need for further study of the mechanisms of multiple organ dysfunction development in acute necrotizing pancreatitis to work out new pathogenetically justified methods of its intensive therapy with an assessment of their effectiveness.

scholarly journals Is intra-abdominal hypertension a missing factor that drives multiple organ dysfunction syndrome?

Critical Care ◽  
2014 ◽  
Vol 18 (2) ◽  
pp. 124 ◽  
Author(s):  
Andrew W Kirkpatrick ◽  
Derek J Roberts ◽  
Jan De Waele ◽  
Kevin Laupland
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Abdominal Hypertension

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

Multiple Organ Dysfunction Syndrome of Alcoholic Origin in an 18-Year-Old Patient

2018 ◽  
Vol 2 (12) ◽  
Author(s):  
Francesco Gazia ◽  
Giacomo De Luca ◽  
Imbalzano Gabriele ◽  
Vincenzo Pellicanò
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction

IMPACT probability of poor outcome and plasma cytokine concentrations are associated with multiple organ dysfunction syndrome following traumatic brain injury

2019 ◽  
Vol 131 (6) ◽  
pp. 1931-1937 ◽  
Author(s):  
Sungho Lee ◽  
Hyunsoo Hwang ◽  
Jose-Miguel Yamal ◽  
J. Clay Goodman ◽  
Imoigele P. Aisiku ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Sofa Score ◽  
Plasma Concentrations ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Poor Outcome ◽  
Initial Plasma

OBJECTIVETraumatic brain injury (TBI) is a major cause of morbidity and mortality. Multiple organ dysfunction syndrome (MODS) occurs frequently after TBI and independently worsens outcome. The present study aimed to identify potential admission characteristics associated with post-TBI MODS.METHODSThe authors performed a secondary analysis of a recent randomized clinical trial studying the effects of erythropoietin and blood transfusion threshold on neurological recovery after TBI. Admission clinical, demographic, laboratory, and imaging parameters were used in a multivariable Cox regression analysis to identify independent risk factors for MODS following TBI, defined as maximum total Sequential Organ Failure Assessment (SOFA) score > 7 within 10 days of TBI.RESULTSTwo hundred patients were initially recruited and 166 were included in the final analysis. Respiratory dysfunction was the most common nonneurological organ system dysfunction, occurring in 62% of the patients. International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) probability of poor outcome at admission was significantly associated with MODS following TBI (odds ratio [OR] 8.88, 95% confidence interval [CI] 1.94–42.68, p < 0.05). However, more commonly used measures of TBI severity, such as the Glasgow Coma Scale, Injury Severity Scale, and Marshall classification, were not associated with post-TBI MODS. In addition, initial plasma concentrations of interleukin (IL)–6, IL-8, and IL-10 were significantly associated with the development of MODS (OR 1.47, 95% CI 1.20–1.80, p < 0.001 for IL-6; OR 1.26, 95% CI 1.01–1.58, p = 0.042 for IL-8; OR 1.77, 95% CI 1.24–2.53, p = 0.002 for IL-10) as well as individual organ dysfunction (SOFA component score ≥ 1). Finally, MODS following TBI was significantly associated with mortality (OR 5.95, 95% CI 2.18–19.14, p = 0.001), and SOFA score was significantly associated with poor outcome at 6 months (Glasgow Outcome Scale score < 4) when analyzed as a continuous variable (OR 1.21, 95% CI 1.06–1.40, p = 0.006).CONCLUSIONSAdmission IMPACT probability of poor outcome and initial plasma concentrations of IL-6, IL-8, and IL-10 were associated with MODS following TBI.

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