Multiple Organ Failure Still a Major Cause of Morbidity but Not Mortality in Blunt Multiple Trauma

Abstract

Although MOF incidence remains unchanged, there is a significant fall in MOF-related mortality in patients with severe trauma, and death from single organ failure is virtually absent. Severe brain injury is now the leading cause of death in patients with severe multiple injuries admitted to the ICU.

Large-magnitude Pelvic and Retroperitoneal Tissue Damage Predicts Organ Failure

“…Previous investigations have focused on the regional impact of head, chest, and/or abdominal trauma on organ dysfunction [7,10,17,22,24,27]. These findings parallel previous observations that severity of regional injury may have greater systemic consequences than the mere presence of a regional insult.…”

“…ISS has been heavily scrutinized for its underrepresentation of multiple severe injuries in one bodily region, underestimation of multiple extremity injury, and its retrospective nature has limited predictive capacity [5,26]. Reports have implicated head injury, chest injury, and abdominal injury in the etiology of organ dysfunction [17,24]. Although surgeons have hypothesized that injury magnitude and distribution affect outcomes after injury, mechanical tissue damage has never been precisely quantified in trauma patients.…”

Treatment of hemorrhagic shock with hypertonic saline solution modulates the inflammatory response to live bacteria in lungs

“…In spite of all the improvements in intensive care, morbidity is still high and the best treatment seems to be prevention (4). The I-R injury associated with the treatment of hemorrhagic shock often primes the lungs to an exaggerated inflammatory response upon a second stimulus, usually of an infectious nature, and may lead to respiratory failure (7).…”

“…In addition, I-R may prime the organism for an exaggerated inflammatory response (massive tissue-Hypertonic saline modulates lung injury www.bjournal.com.br cellular infiltration and edema) to a secondary stimulus such as infection, with devastating consequences (3). These so-called two-hit injuries occur with remarkable frequency in trauma patients who suffered hemodynamic instability (4). The lungs are, most commonly, the target of this second injury (5), morphologically characterized by alveolar and interstitial fluid accumulation, alveolar hemorrhage, fibrin deposition, and lung neutrophil sequestration (6).…”

Significance of Elecsys® S100 immunoassay for real-time assessment of traumatic brain damage in multiple trauma patients

“…Apart from massive bleeding due to vascular or parenchymal injuries, early mortality within 24 h after trauma is mainly influenced by severe TBI, whereas late mortality may be determined by severe organ dysfunction up to multi-organ failure (3,4).…”