Multiple Organ Dysfunction Syndrome Magpayo

7/29/2019 Multiple Organ Dysfunction Syndrome Magpayo

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Multiple Organ Dysfunction

Syndrome

Magpayo, Allen Jerome



Defined as:

• Altered organ function in an acutely ill

patient that requires medical intervention to

support continued organ function.

• Reversible physiologic derangement

involving two or more organ systems.



Risk factors/Causes•

Advanced age ( >65 y/o)• Infection

• Burn ( 3rd degree)

• Coexisting disease (Diabetes)

• Perfusion deficits (Liver, Lungs, kidneys, Heart andBrain)

• Severe injury or trauma

• Complication of shock (Septic, hemorrhagic,

anaphylactic, hypovolemic, cardiogenic andneurogenic)

• SIRS (Systemic inflammatory response syndrome)

• Fluids and electrolytes imbalances



Risk factors

Pathophysiology

MODS(Primary)Direct tissue

damage or

injury

(Secondary)Complication

of shock



Neuroendocrine system is activated and release of

inflammatory mediators ( Histamine, Bradykinin )

occur

Immune/Inflammatory response results

to local organ tissue congestion

Inadequate distribution of systemic and organ

blood flow

Tissue hypoperfusion



Impaired cellular function

Organ dysfunction/ failure

(Lungs, Liver, Kidneys, Heart, GIand Brain)

DEATH



N- 5-7 mmHg



Signs and Symptoms

>Renal dysfunction

• Progressive oliguria

• Hyperkalemia

•

Azotemia• Metabolic acidosis

• Anuria



>Respiratory dysfunction

• Dyspnea

• Tachypnea

• Hypoxemia

• Pulmonary edema withcrackles

• Diminished breath

sounds• Use of accessory

muscle

Signs and Symptoms



>Neurogenic dysfunction

• Hypotension

• Warm dry skin

• Bradycardia

• Hypothermia

• Loss of consciousness

Signs and Symptoms



Signs and Symptoms

>Liver dysfunction

• Jaundice

• Abdominaldistention

• Liver tenderness• Muscle wasting

• Hepatic

encephalopathy• Impaired

metabolism



>GI dysfunction

• Hemorrhage

• Malabsorption

•

Diarrhea/constipation• Vomiting

• Anorexia

• Abdominal pain

Signs and Symptoms



>Cardiac dysfunction

• Tachycardia

• Bounding pulse

•

Increase cardiacoutput

• Decrease SVR

•Hypotension

• Ventricular

dysrhythmias

Signs and Symptoms



Diagnostic test• Physical assessment

•

Liver function test• BUN and creatinine test

• Serum electrolytes

•Arterial blood gases

• ECG

• EKG

•CT-scan

• MRI

• Chest x-ray

• CBC

•Serum bilirubin

• Prothrombin time



Nursing diagnosis

• Ineffective cerebral, renal, gastrointestinal,

myocardial and hepatic tissue perfusion

• Imbalanced nutrition: less than body

requirements

• Activity intolerance

• Severe anxiety



Management:• Prevention of complications is the top priority

• If preventive measures fail, treatment measures toreverse MODS are aimed at controlling the initiating

event, promoting adequate organ perfusion and

providing nutritional support.Medical:

-Antibiotics

-Intravenous fluids

-Oxygen administration (as prescribed)



Nursing Intervention

-Primary goal is to support patient and monitororgan perfusion until primary organ insults are

halted

•

Assess for signs of infection• Assess the level of consciousness of the patient

• Assess the physical features of the patient

• Monitor vital signs hourly• Monitor Intake and Output hourly



• Monitor laboratory findings

• Provide a quiet and comfortable environment

• Encourage patient to make an opencommunication about treatment modalities

• Encourage patient to rest frequently as possible

• Encourage patient to comply with his or hermedications

• Encourage patient to do deep breathing exercises

and range of motion exercises if unable to walkon his or her own

Documents

Multiple Organ Dysfunction Syndrome Magpayo