《基础医学各论3》资料：MODS 2013

1、Multiple Organ Dysfunction Syndrome (MODS),Jianzhong Sheng MD, PhD Department of Pathophysiology School of Medicine Zhejiang University,Definition,Dysfunction or failure of multiple organ or system happened simultaneously or sequentially due to various etiological factors.,Etiology,Infection: Gram p

2、ositive/negative bacteria, fungal, Virus Shock :hemorrhage, etc. Allergy Burns Trauma Severe acute pancreatitis,Classification of MODS,Immediate Type (Primary)：Dysfunction are happened simultaneously in two or more organs due to primary disease. Delayed type (Secondary）：Dysfunction happened in a org

3、an, other organs sequentially happened dysfunction or failure. Accumulation type：Dysfunction leaded by chronic disease.,Attention,Immediate Type Not related to SIRS Coup injury with chemical or physical factors No time interval from disease ARDS+ARF or ARDS+ARF+DIC+LF,Delayed type Not the direct out

4、come from injury Relating to SIRS（systemic inflammatory response syndrome） Time interval existed from primary disease,Accumulation type Accumulation Irreversible,ARDS: acute respiratory distress syndrome ARF: acute renal failure LF: liver failure,Mechanism,Inflammatory mediators priming SIRS leading

5、 to MODS,Vascular permeability PMN chemotaxis,Mono / Macrophage,PMN,elastase PLA2 oxygen free radicals,TNF IL8 IL1 IL6,Liver： acute phase,Remote organ injury,Tissue injury,Endothelium,Injury factors,PMN,PAF,Adhensive molecules,DIC,polymorphonucleocyte,PAF, platelet activating factor,Common Manifesta

6、tions of MODS,Diagnosis of Criteria,Organ/ system dysfunction and failure,GLASGOW SCORE,Treatments of MODS,Combined therapy Correction of ischemia: fluid resuscitation, mechanical ventilation Prevention of infection：drainage, antibiotics Interruption of pathological reaction：hemofiltration Stabilization of internal environment：water, electrolyte, acid-base imbalance Regulation of immunity：cellular and humor,Support of organ function Ventilator