Multi-organ Dysfunction Syndrome

TL;DR: The ESICM developed a so-called sepsis-related organ failure assessment (SOFA) score to describe quantitatively and as objectively as possible the degree of organ dysfunction/failure over time in groups of patients or even in individual patients.

Abstract: Objective:To define the terms “sepsis” and “organ failure” in a precise manner. Data Sources:Review of the medical literature and the use of expert testimony at a consensus conference. Setting:American College of Chest Physicians (ACCP) headquarters in Northbrook, IL. Participants:Leadership members of ACCP/ Society of Critical Care Medicine (SCCM). Results:An ACCP/SCCM Consensus Conference was held in August of 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae. New definitions were offered for some terms, while others were discarded. Broad definitions of sepsis and the systemic inflammatory response syndrome were proposed, along with detailed physiologic variables by which a patient could be categorized. Definitions for severe sepsis, septic shock, hypotension, and multiple organ dysfunction syndrome were also offered. The use of severity scoring methods were recommended when dealing with septic patients as an adjunctive tool to assess mortality. Appropriate methods and applications for the use and testing of new therapies were recommended. Conclusion:The use of these terms and techniques should assist clinicians and researchers who deal with sepsis and its sequelae.

TL;DR: This multiple organ dysfunction score, constructed using simple physiologic measures of dysfunction in six organ systems, mirrors organ dysfunction as the intensivist sees it and correlates strongly with the ultimate risk of ICU mortality and hospital mortality.

TL;DR: The goals of this review are to integrate the vast amount of new information on the basic biology of MOF and to focus special attention on the potential therapeutic consequences of these recent advances in the authors' understanding of this complex and perplexing syndrome.