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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2002 April;15(2):51-4
MOF: an experience of clinical and biochemical monitoring for prognostic evaluation
Sammartano A., Giammanco M., Di Prima G., Raimondo D., Vetri G., Frazzetta M., Di Gesù G.
Background. MOF is a clinical syndrome, characterised by alterations in the metabolic functions in different organs of critically patients. Even nowadays, its mortality rate is very high (60 to 80%). It represents the unfavourable evolution in most cases of septic, hemorrhagic, traumatic shock. The aim of the present work is to correlate the physiopathological evolution of the observed clinical pictures with the correspondent biochemical elements emerging from the monitoring performed in our experience during the emergency surgery activity.
Methods. From May 1993 to March 2000, 548 patients were admitted in emergency pattern to this Hospital; 195 of them underwent surgical interventions for acute abdominal pathology; 23 presented a picture of septic shock at their arrival. The mortality risk of this last group of patients was evaluated by APACHE score and by the analysis of different clinical and laboratory parameters. Six of them showed a picture of MOF.
Results. Leukopenia, leukocytosis, hyperglycaemia, hyperuricemia, hyperfibrinogenemia, progressive reduction of the platelets and high temperature are considered as negative prognostic factors for the evolution from septic shock to MOF. Four of the patients suffering from MOF with alteration of the above mentioned parameters died after being moved to our Intensive Care Unit.
Conclusions. There is a number of shock conditions showing a premature evolution to MOF. These conditions should be identified as early as possible, due to the difficulties of management and of treatment they usually induce. From a clinical and physiopathological perspective, all these conditions represent one of the most interesting fields of research, whose results are closely correlated to the progress of modern surgery.