Organ dysfunction

The systemic inflammatory response, which is activated by proinflammatory mediators released by local phagocytes in the injured area, is characterized by a progressive and sequential dysfunction of multiple remote organs, such as the lung, kidney, brain, and clotting system, and of intraperitoneal organs such as the liver and the gut (multiple organ failure). The presence and severity of these organ dysfunctions can be quantified with the multiple organ failure score ( Table 1) (Goris ef al 1985). Patients with multiple organ failure are regularly characterized by fever, generalized permeability edema, and increased susceptibility to hospital-aquired infections, particularly bronchopneumonia and urinary tract infections. Despite intensive support of failing organ systems, the mortality of full-blown multiple organ failure is still about 60 percent ( Roumenefa/ 1993).

Table 1 Multiple organ failure score

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