MAJOR TRAUMA AND MULTIPLE ORGAN DYSFUNCTI ON SYNDROME (MODS) - DEFINITION, PATHOPHYSIOLOGY, THERAPY

The multiple organ dysfunction syndrome (MODS) with a mortality of 50 % to 70 % represents the number 1 cause of death in surgical intensive care units. It is divided in a primary and a secondary MODS based on time of manifestation and pathophysiological events which attribute to it. The therapy of the primary MODS includes sufficient and quick res uscitation, adequate oxygen delivery and early enteral nutrition to re duce or avoid the incidence of bacterial translocation. In addition, a reduction of the antigenic load by control of hemorrhage, radical wou nd debridement, decompression, and fixation of long bone fractures app ears to be effective in reducing the occurence of MODS. The treatment of the secondary MODS remains supportive and its prevention is essenti al. Further studies have to be carried out to evaluate the clinical si gnificance of new therapeutical agents such as monoclonal antibodies o r cytokine receptor antagonists.