One of the most feared complications that can occur during medical treatment is multi- organ failure. Only about half of the patients affected survive if several organs such as the kidneys, lungs or heart fail at the same time.
What is multi-organ failure?
If necessary, the organs can be replaced by machines for a time. If the brain or liver is affected by the failure, the patient can usually no longer be helped. In order to have a chance of survival in the event of multiple failure of various organs, the patient must be treated in intensive care. See foodezine for Everything about Hyponatremia.
However, multi- organ failure often only occurs in the intensive care unit. However, it is usually recognized very quickly there. Despite quick countermeasures, this complication remains one of the most common causes of death in intensive care units.
Basically, multi-organ failure is very simply defined. If two or more organs stop working at the same time, this is already a multi-organ failure. However, doctors now speak of a multiple organ dysfunction syndrome, abbreviated to MODS.
Causes
There are various reasons that can lead to multi -organ failure. The two most important are accidents and bacterial poisoning.
If several organs are injured in an accident, this can lead to a chain reaction that leads to the failure of other organs. The same applies to the dreaded sepsis. This is a form of poisoning that spreads rapidly throughout the body and can lead to severe inflammation everywhere.
Heart diseases or allergies can also trigger multi-organ failure. This can be the case when the patient experiences life-threatening anaphylactic shock, which can paralyze the circulatory system and various organs. Another cause, on the other hand, is simply old age. In a very old and very weak body, the failure of one organ can quickly bring down the others.
Symptoms, Ailments & Signs
The symptoms of multi-organ failure result from the respective insufficiency of the affected organs. Manifest kidney failure is expressed in a decrease in the filtering capacity of the kidneys. Substances that have to be passed through the urine, water and electrolytes remain in the body. This can lead to overhydration with cerebral edema, pulmonary edema or heart failure.
Liver failure manifests itself in yellowing of the skin (icterus) and blood coagulation disorders with prolonged bleeding times. Likewise, disturbances of consciousness up to coma can occur. The patients smell from the mouth of raw liver (foetor hepaticus) and show a so-called flapping tremor.
It is a gross shaking of the hands. Because bile leaks from the vessels in the liver into the blood, people with liver failure also experience itching. This is particularly noticeable on the foot. Rapid breathing and shortness of breath are the main symptoms of acute lung damage.
Due to the lack of oxygen supply, the patient’s skin turns blue. This is also referred to as cyanosis. Restlessness and confusion are other symptoms that can occur with lung failure. A drop in body temperature (hypothermia) or a rise (hyperthermia) to the point of fever can also be observed in some patients.
Diagnosis & History
The exact diagnosis of multi -organ failure naturally depends on which organs are affected. However, since this complication usually occurs in intensive care units, the failure of various organs is usually recognized very quickly and the nursing and treating staff are notified by technical means. The moment multiple organ failure is recognized, action must be taken very quickly, as any delay dramatically reduces the patient’s chances of survival.
Complications
A multi-organ failure as a result of a serious illness, infection, shock reactions, allergies or a serious nutrient deficiency is already a complication that increases in severity with the number of failing organ systems. If the functions of individual organs have to be compensated for by intensive care measures, this involves considerable interventions in the patient. Surgery and organ removal may be necessary, which again entail risks of their own.
The removal of organs leads to a lifelong dependency on machines such as dialysis machines (kidneys) or ventilators (in the case of a failing lung). The occurrence of sepsis, which can occur as a result of dead organs and cell and metabolic toxins released into the body, is particularly dangerous. The poisoning causes further inflammation and the loss of other organ functions.
In addition, as a result of multiple organ failure, or even an initiated coma in such a case, an insufficient supply of oxygen to brain areas can occur. The damage caused is irreversible and subsequently affects those affected forever.
If the liver or the brain is affected by sepsis, which occurs in the course of multiple organ failure, the medical measures are exhausted. The same applies to complete liver failure as part of multiple organ failure. Brain death is equivalent to death. The mortality rate increases with the number of failing organs and the sequelae.
When should you go to the doctor?
In the event of multi-organ failure, an ambulance must be called immediately or the hospital must be visited directly. If no rapid medical treatment is initiated, the multi-organ failure usually leads to the death of the person concerned. The sooner the disease is diagnosed and treated, the better the chances of a person’s recovery. In most cases, however, the patient with multi-organ failure is already in a hospital or receiving other medical treatment.
The patients suffer from severe pain, fever, shortness of breath and disturbances of consciousness. They are often no longer able to walk, eat or drink on their own and need help from other people in their everyday lives. If these symptoms occur, a doctor must immediately carry out an examination. It can also lead to heart failure or kidney failure. Cyanosis or other breathing difficulties can also indicate multi-organ failure and should be examined.
The treatment depends heavily on the organs affected and is usually carried out in a hospital. However, it cannot generally be predicted whether this will lead to a positive course of the disease. The life expectancy of those affected is often significantly reduced by multi-organ failure.
Treatment & Therapy
The treatment of multi -organ failure naturally depends on the organs affected, but also on the cause of the complication. If, for example, sepsis is the starting point for organ failure, the focus of inflammation must be identified and eliminated as quickly as possible, and the patient is also treated with antibiotics. In the case of more severe external injuries, such as those caused by an accident, the function of the affected organs may have to be supported mechanically or even replaced.
An important means in the treatment of multi-organ failure is the artificial coma. Doctors, however, prefer the term “artificial deep sleep”. The patient is put into a coma-like state using various medications. This is to protect the brain from the effects of multiple failure of the organs. When the brain is affected, there is usually no salvation for the patient.
Regions of the brain that are affected by a MODS, for example due to a lack of oxygen, remain irrevocably damaged. Through the artificial deep sleep, all bodily functions are significantly shut down. The body temperature also drops. As a result, certain body regions can regenerate more easily or the affected organs can be better treated and set in motion again.
Outlook & Forecast
If a patient develops multi-organ failure, the chance of survival is very low. This depends on the restricted or failed organs and the possibility of treatment. If multiple organ failure is not treated promptly, death is inevitable. There is no prospect of spontaneous healing or anything like that. The mortality rate for three failed organs is still around 80 percent, even with medical treatment.
Those affected can be partially stabilized and kept alive in an intensive care unit. How well this succeeds depends on the failed organs. For example, it is easier to replace kidneys and lungs than, say, the liver or heart. The failure of the cardiovascular system is almost always fatal. Artificial ventilation can sometimes be maintained for a very long time. A failed gastrointestinal tract can also be compensated. Since those affected in this state usually fall into a coma or are put into one, at least the suffering seems to be limited.
If several organ systems fail, it is often no longer to be expected that those affected will recover well, even when they have come out of the coma. At most, this would be the case if a few, ideally non-vital, organ systems were to fail.
Prevention
Accidents are difficult to prevent. Against infections, on the other hand, yes. 15 percent of all patients in German intensive care units suffer from a so-called nosocomial infection. Behind this is the dreaded “hospital infection”. This can lead to multi-organ failure, especially if the infection was caused by resistant pathogens.
Therefore, one of the most important preventive measures against multiple organ failure is a very pronounced and meticulous hospital hygiene. Allergy sufferers, on the other hand, should avoid any situation that could lead to an allergic shock. That is why it is fundamentally important to know exactly what your allergy behavior may be.
Aftercare
In most cases, multi-organ failure leads to a reduced life expectancy. Then the aftercare can only assume a palliative character. Doctors try to counter the failure of vital organs. Intensive care treatment is indicated. Since there is little time left, pastoral conversations play an important role.
If multiple organ failure is survived, consequential damage usually remains. These require long-term treatment. Many patients are dependent on dialysis for the rest of their lives. A normal everyday life is hardly possible. Taking medication is important to stop the symptoms. Follow-up checks at short intervals are common.
The type of follow-up examination depends on the respective clinical picture. An interview and a physical examination take place regularly. Blood is also drawn frequently. Imaging procedures regularly support the diagnosis and provide clear conclusions about the course of the disease. Other outpatient therapies may be prescribed.
If patients belong to the small group of people in whom no secondary diseases remain, no follow-up care is necessary in view of the freedom from symptoms. However, experience has shown that many of those affected have problems finding their way back into their everyday lives. Therefore, doctors often prescribe sessions with a psychotherapist to achieve stabilization.
You can do that yourself
Multiorgan failure is often fatal, even if it occurs in an intensive care unit and doctors anticipated this dreaded complication. They may put the patient in an artificial coma or remove affected organs, such as the kidneys.
This has consequences for the survivor that have a significant impact on his or her future life. He may need dialysis and/or other therapies for the rest of his life. These therapies should never be left out. This also applies to physiotherapy, which is intended to mobilize the patient again.
Having stood so close to death’s threshold leaves no patient untouched. Even if no sequelae remain, the sufferer will have trouble resuming their previous life. In any case, he should seek psychotherapeutic treatmentembark Group therapies with other patients are also advisable. Addresses and contact persons are provided by the treating clinics. Since multiple organ failure is often a complication of sepsis, the website www.sepsis-hilfe.org also offers information and assistance. The reports of those affected who have survived multi-organ failure are particularly helpful here. There is no way to prevent multiple organ failure after an accident or in old age. Sepsis, on the other hand, can be prevented, which also prevents multi-organ failure.
