Full and stable operation of all systems and organs in the human body is one of the key conditions for vital activity. But with the influence of certain factors, the normal state of the body can be seriously threatened, which can lead to a fatal outcome. We are talking about polyorgan insufficiency - a disease that has an extremely destructive effect on the key systems of the body.
What is the danger of multiple organ failure?
Under this disease is to understand the severe non-specific stress response of the body with the total failure of several functional systems. In this case, the progression of diseases occurs according to the principle of the development of most injuries and acute diseases at the terminal stage.
As a key feature of multiple organ failure, it is possible to determine damage to a system or organ at such a level that it loses its ability to maintain the body’s vital activity. If we take the statistics of the wards of intensive care and resuscitation of surgical hospitals, then the syndrome will account for up to 80% of all deaths.
Such an indicator as the severity of multiple organ failure is determined, taking into account the following factors: the initial functional state of the organ itself (directly depends on the physiological reserve), reduced blood flow, the organ’s ability to resist hypoxia, shock factors (septic, cardiogenic, hypovolemic), metabolic disorders.
Causes of the disease
Multiple organ failure can result from exposure to the body of various infections, injuries, hypermetabolism, or tissue hypoperfusion. The presence of these factors does not guarantee the occurrence of the disease, but each of them has enough potential to lead to the disease. As for cellular damage, the influence of mediators plays an important role in them. What concentration will have to be dealt with during release depends on the severity of the damaging factor.
In some cases, the transfusion of canned blood of long periods of storage in large quantities can also lead to such a condition as multiple organ failure. The causes of this disease are sometimes associated with unqualified artificial lung ventilation.
If you touch the scope of surgery, then the key causes of the stress response of the body is to highlight the infectious, which cause impaired metabolism, the immune status of patients and the system of homeostasis. MON develops as a complication of the postoperative period (7-22%), and as for the purulent complications of acute inflammatory diseases, this diagnosis is made in 50% of cases.
The effect of infection on the development of multiple organ failure
Multiple organ failure can result from septic processes and impaired immunity. In most cases, sepsis develops due to exposure to gram-negative bacteria that enter the bloodstream and organs through the gastrointestinal tract. Therefore, the opinions of many researchers agree that the gastrointestinal tract plays the role of a generator of multiple organ failure.
Disruption of homeostasis, inflammatory mediators, microcirculation damages, bacterial toxins and endothelial damage can be considered as components of the disease development process.
Speaking of the clinical picture, the syndrome of multiple organ failure should be divided into several key states:
- acute liver failure;
- violation of the functions of the central nervous system;
- adult respiratory distress syndrome;
- DIC (it is also called disseminated intravascular coagulation syndrome).
The complications listed above are the main causes of death in intensive care units. Depending on how many organs are in a state of insufficiency, the probability of death of patients changes.
As a key link triggering processes, the consequence of which is acute multiorgan failure, it is possible to determine the violation of metabolism. This pathology is a response to damage of a systemic nature, regardless of what etiological factor was the source (polytrauma, burns, infections, ischemia).
Multiple organ failure can also be identified as the final stage of the hypermetabolic systemic response of the body to a specific damage, which is manifested by an acute pulmonary disorder leading to the development of hepatic and renal failure, as well as to the dysfunction of other human organs.
In the terminal stage of the disease, a pronounced catabolism can be observed. The cause for its occurrence is the grave condition of the patient with an irreplaceable energy deficit. As a result, there is a development of protein-dependent energy metabolism, which is based on the breakdown of proteins and the activation of proteolysis of muscle tissue, as well as vital organs. The consequence of this process is the release of substances that provoke cell and tissue damage by activated microbial and viral toxins, macrophages and mast cells.
At the same time, as a result of trauma, patients may develop a systemic inflammatory response syndrome, the severity of which depends on the volume of the affected tissue, the degree of shock and the innate properties of the organism itself.
Multiple organ failure: developmental phases
While progressing, PON syndrome consistently moves from one phase to another:
1. Induction. At this stage, a synthesis of various humoral factors is formed, which trigger the systemic inflammatory response.
2. Cascade. This phase is accompanied by the activation of the kallikrein-kinin system, the development of acute lung damage, and the activation of the blood coagulation cascades and the arachidonic acid system.
3. The secondary phase of autoaggression. At this stage, there is an extremely severe organ dysfunction and stable hypermetabolism. At this time there is a loss of body ability to self-regulation of homeostasis.
ICD. Multiple organ failure
In order to clearly understand the essence of the diagnosis made by the doctor, you should familiarize yourself with the system of special codes that are contained in the International Classification of Diseases and Problems Related to Health.
The disease hierarchy system in this case is amenable to simple logic. First comes the letter designation (Latin alphabet), which defines a group of diseases, such as pathology of the circulatory system. The following is a two-digit numeric code indicating the particular ailment. The third symbol contains information about any type of disease or its complication.
Many people are wondering what is the ICD-10 code of multiple organ failure? It should be noted that this pathology has no code as such, since it is associated with an impact on various systems and organs. Nevertheless, the characteristics of the stress response can be found in several categories of classification. In other words, the International Disease Definition System gives a description of a given condition, but collectively.
Renal failure is directly related to a disease such as multiple organ failure (ICD-10, N 19). Also relevant is N 17, which is assigned to acute renal failure, which is a component of multiorgan. It makes sense to mention and 85 - acute pancreatitis.
J 96, which we should understand as respiratory failure, is related to the pathology we are considering. Septic shock also refers to a disease such as multiple organ failure (ICD-10 code, A 41.9 “Septimization, unspecified”).
Thus, having at hand the International Classification of Diseases, you can get the necessary information regarding the established diagnosis.
To prevent the stress response of the body is possible. To do this, it is necessary to undergo timely diagnosis in order to prevent the transition of severe pathology or any other disease to a critical stage. This is actually the key method by which you can stop the development of multiple organ failure.
For the successful implementation of such a preventive scheme, functional assessment and monitoring are required, followed by normalization of blood circulation, elimination of infection, energy supply, normalization of metabolism and respiration, as well as early treatment of inflammation, trauma and necrosis.
When neutralizing such a complex problem as multiple organ failure, the correct step-by-step action is important. It is about artificially replacing or maintaining systems, the violation of which can be fatal. In most cases, it is the circulatory and respiratory system.
Further, it is necessary to conduct a semi-functional study, with the help of which it is necessary to determine the degree of damage to organs and systems. The next step is to enhance the correction of physiological mechanisms. Then the affected systems are treated and removed from the critical state.
Another way to influence the multiple organ failure is the anti-mediator effect. In other words, it is necessary to block endothelial cell receptors.
An important element of the treatment system is the normalization of the energy balance, which means the creation of acid-base balance, metabolic correction, mixed, enteral and parenteral nutrition, the introduction of amino acids and vitamins necessary to normalize the activity of enzymes.
We can not neglect the adequate supply of oxygen to the tissues through the normalization of microcirculation systems and lung function.
The development of multiple organ failure is too great a risk to human life. There is no guarantee that when systems of the body, like the bodies themselves, will begin to shut down, doctors will be able to reverse the destructive process and save the patient. Therefore, in case of serious injuries and developing infections must, without delay, to go to the doctor and undergo treatment.
Preventing multiple organ failure is significantly easier and cheaper than treating an already progressive disease.