Multiorgan dysfunction Flashcards
Endothelial Clells Function
“Cross Talk”
- tell erythrocytes, platelets, leukocytes, and muscle cells what to do
- release mediators
- **REGULATE PERMEABILITY
Mediators:
- released by
- elicit
- recruit
- promote
- endothelial cells
- inflammatory response
- WBC to area
- localized clotting
- contains the infection
Systemic Inflammatory Response Syndrome (SIRS)
- systemic inflammatory response
- even in the absence of infection
What is the name of SIRS if an infection is present
Sepsis
What are common complications of SIRS
MODS- multi organ dysfunction system
ALI-
ARF-acute renal / resp. failure
Criteria for SIRS
pt has 2 of 4 s/s of SIRS
SIRS patho
inflammatory response is no longer contained and reaches uninvolved epithelial cells. Unregulated inflammatory response
Populations at risk for SIRS
- > 65 y/o
- trauma pt
- alcohol and drug abusers
- genetics that lead to infections
- burn pts
S/S SIRS
- temp >100.4
- HR >90
- RR >20 or PaCO2 12,000 or 10% immature cells (bands)
Clinical conditions associated with SIRS
- infection
- pancreatitis
- ischemia
- shock
- trauma
- exogenous administration of cytokines
- aspiration
- massive transfusions
- host defense abnormalities
MODS
-failure of 2+ organs
MODS:
what is client outcome associated with?
assoc with number of organs that fail with mortality increasing 15-20% with failure of each organ
MODS:
mortality of 80-100% failure
3+ organ failure
MODS:
who have the highest susceptibility?
Sepsis and Trauma pts
PRIMARY MODS
- results from a well defined insult
- result of inadequate oxygenation delivery to cells and a failure of microcirculation to remove metabolic end products
PRIMARY MODS
-causes
- Trauma
- pulmonary contusion
- aspiration
- renal dysfunction
- thermal injury
SECONDARY MODS
consequence of widespread systemic inflammation
-involves other organs and is not defined
SECONDARY MODS:
-result of
- late organ dysfunction
- result of generalized SIRS or sepsis
Pathologic changes with MODS
- uncontrolled systemic inflammation
- tissue hypoxia
- unregulated cell death
- microvascular coagulopathy
Inflammatory Cells
neutrophils macrophages mast cells lymphocytes endothelial cells
**Inflammatory cell functions
Produce and release mediators
Plasma protein synthesis
Complement
kinin
coagulation
FUNCTIONS: **Leukotrienes
Bradykinin
Prostaglandins
Oxygen free radicals
affect vasomotor tone and vascular permeability
FUNCTIONS: **
Interleukins
Cytokine that causes vascular congestion, capillary leakage, and increased coagulation
