Abstract
Objective
To evaluate the role of infection and systemic inflammatory response syndrome (SIRS) on the occurrence of early posttraumatic MODS.
Design
Retrospective study.
Setting
University Teaching Hospital ICU.
Patients
163 consecutive patients hospitalized for more than 48 hours following severe trauma.
Measurements and main results
The patients were classified into two groups in respect to the existence of MODS at day 2. There was 27 patients in the MODS group and 136 patients in the no MODS group. The two groups were similar with respect to age, sex ratio and Simplified Acute Physiology Score. The MODS group had a higher mortality (52 versus 7%), Injury Severity Score (45±14 versus 31±13), hypovolemic shock rate (74 versus 30%), massive volume replacement rate (59 versus 6%) and SIRS rate (81 versus 54%) than the no MODS group (p<0.05). The rate of infection was similarly low in the MODS and no MODS group (4 versus 6% respectively).
Conclusion
Early MODS is often associated with hypotension and massive volume administration but very rarely with infection, despite the high rate of SIRS.
Similar content being viewed by others
References
Faist E, Baue AE, Dittmer H et al (1983) Multiple organ failure in polytrauma patients. J Trauma 23:775
Goris RJA (1991) Pathophysiology of multi-organ failure. An overview. Clin Intensive Care S2:5
Fry DE, Pearlstein L, Fulton RL et al (1980) Multiple system organ failure. Arch Surg 115:136
Henao FJ, Daes JE, Dennis RJ (1991) Risk factors for multiorgan failure: case control study. J Trauma 31:74
Waydhas C, Nast-Kolb D, Jochum M et al (1992) Inflammatory mediators, infection, sepsis and multiple organ failure after severe trauma. Arch Surg 127:460
Goris RJA (1980) The injury severity score. World J Surg 7:12
Legall JR, Loirat Ph, Alperovitch A et al (1984) A simplified acute physiology score for ICU patients. Crit Care Med 12:975
Moore FA, Moore EE, Poggetti R et al (1991) Gut bacterial translocation via the portal veins: a clinical perspective with major torso trauma. J Trauma 31:629
American College of chest Physicians/Society of Critical Care Medicine Consensus Conference (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864
Armitage P, Berry G (1987) Statistical methods in medical research. Blackwell, Oxford
Goris RJA, Te Boekhorst TPA, Nuytinck JKS et al (1985) Multiple organ failure. Generalized autodestructive inflammation? Arch Surg 120:1109
Fowlers AA, Hamman RF, Good JT et al (1983) Adult respiratory distress syndrome risk with common predispositions. Ann Intern Med 98:593
Lauwers LF, Rosseel P, Roelants A et al (1986) A retrospective study of 130 consecutive multiple trauma patients in an intensive care unit. Intensive Care Med 12:296
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Smail, N., Messiah, A., Edouard, A. et al. Role of systemic inflammatory response syndrome and infection in the occurrence of early multiple organ dysfunction syndrome following severe trauma. Intensive Care Med 21, 813–816 (1995). https://doi.org/10.1007/BF01700964
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01700964