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Multiple Organ Dysfunction During Resuscitation Is Not Postinjury Multiple Organ Failure
David J. Ciesla, MD;
Ernest E. Moore, MD;
Jeffrey L. Johnson, MD;
Angela Sauaia, MD, PhD;
Clay C. Cothren, MD;
John B. Moore, MD;
Jon M. Burch, MD
Arch Surg. 2004;139:590-595.
Hypothesis Multiple organ dysfunction (MOD) within 48 hours of injury is a reversible physiologic response to tissue injury and resuscitation.
Design A prospective 10-year inception cohort study ending September 2003.
Setting Regional academic level I trauma center.
Patients One thousand two hundred seventy-seven consecutive trauma patients at risk for postinjury multiple organ failure (MOF). Inclusion criteria were being 16 years and older, being admitted to the trauma intensive care unit, having an Injury Severity Score higher than 15, and surviving more than 48 hours after injury. Isolated head injuries were excluded.
Interventions None.
Main Outcome Measures Development of postinjury MOD as defined by a Denver MOF score of 4 or higher within 48 hours of injury and MOF as defined by a Denver MOF score of 4 or higher more than 48 hours after injury.
Results Postinjury MOD and MOF were diagnosed in 209 (16%) and 300 (23%) patients, respectively. Age, Injury Severity Score, and 12-hour blood transfusion requirements were significantly higher among patients who developed MOD and MOF. Of the 209 patients who developed MOD, 134 (64%) progressively developed MOF while 75 (36%) had MOD resolve within 48 hours.
Conclusion Multiple organ dysfunction during resuscitation is a reversible response to severe injury and often resolves during the resuscitation period.
From the Denver Health Medical Center and the University of Colorado Health Sciences Center; Denver.
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A 12-Year Prospective Study of Postinjury Multiple Organ Failure: Has Anything Changed?
Ciesla et al.
Arch Surg 2005;140:432-440.
ABSTRACT
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