Multiple organ failure
Multiple organ dysfunction syndrome (MODS) or multiple organ failure is a serious condition involving the failure of tow or more organ systems. This can include any combination of acute renal (kidney) failure, heart failure, respiratory failure or liver failure.
Multiple organ failure generally is a secondary phenomenon. The causes behind such a condition are an uncontrolled inflammatory response or infectious response from a severe illness or injury. Septic shock or shock from an infectious agent is the most common cause of MODS. Severe trauma with excessive muscle and tissue damage can also cause this condition. In some cases, a prolonged shock-like condition from a massive heart attack can cause this cluster of symptoms.
The symptoms of MODS depend on the systems failing. The condition of hepatorenal syndrome is a combination of renal failure and liver failure. In fact, this combination of organ failures is not uncommon as both are organs that attempt to rid the body of toxicity and products of metabolism.
There are two types of hepatorenal syndrome. In type 1 disease, the kidneys fail quite rapidly, resulting in fluid retention, blood pressure fluctuations, jaundice, ascites (excess belly fluid), itching and a decreased level of consciousness. Only 10% of people with this type of hepatorenal syndrome survive after 10 weeks, with a median survival time of less than two weeks.
In type 2 hepatorenal syndrome, the kidney failure is more gradual, allowing the body to compensate for some of the double organ failure. The survival rate of this type of hepatorenal syndrome is 50% at 5 months and 20% at one year.
The combined failure of the respiratory system and the cardiovascular system is also not uncommon as the two organs function quite closely with one another. Cardiac or respiratory failure can be the initiating disease state. If the respiratory system fails, such as in overwhelming sepsis and pneumonia, the blood is poorly oxygenated and the heart muscle cannot function well. Without adequate oxygenation, the liver and the kidneys don’t function well either but are not as sensitive to low oxygen as is the heart.
When the heart begins to fail, it can’t properly pump the blood into the body and the backup of blood causes fluid to leak into the lung tissues, resulting in pulmonary edema or fluid-filled lungs. Lungs filled with fluid are further restricted from providing oxygenated blood to the body. The end result is a vicious cycle that ends in cardiopulmonary collapse.
In the case of septic shock, the blood pressure becomes so low that the kidneys, the liver, the lungs and the heart itself do not receive adequate blood flow. Unless corrected quickly, all of the body’s organs and systems shut down, resulting in a nearly 100% mortality rate.