SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS), MULTIPLE ORGAN DYSFUNCTION SYNDROME (MODS), MULTIPLE ORGAN FAILURE (MOF) - ARE WE WINNING THE BATTLE

The problems of inflammation and infection leading to organ dysfunctio n and failure continue to be the major problems after injury and opera tions and with intensive care for many diseases and problems. When SIR S goes to MODS and MOF, the mortality becomes high, ranging from 30-80 % depending on the number of failed organs. In spite of this, there ha ve been recent exciting discoveries and contributions to patient care. A reasonable question then is, are we making progress and if so, can we document it? Are the incidence and mortality of MOF decreasing? The literature comparing care over some years suggests a decrease in ICU mortality in patients with severe organ failure, a decrease in electiv e surgical mortality, and improvement in the results of care and outco me for trauma patients. Review of problems occurring in sick and injur ed patients indicates that certain problems are decreasing in frequenc y, such as renal failure and ARDS after trauma, stress gastrointestina l bleeding, and abdominal abscesses, and these should improve outcome. There are a number of exciting therapies that help certain patients b ut not everyone. These controversies challenge us to focus on where an d when there are positive benefits. Risk factors for MOF are addressed to focus on early intervention. The possibilities of multiple therape utic agents are described. Finally, we describe and emphasize our reco mmendation to strive to prevent MODS and SIRS.