Prospective study of 17 cases of postburn multiple organ failure / 第三军医大学学报

ABSTRACT

Seventeen cases of postburn multiple organ failure (MOF) were studied prospectively.It was found that MOF mainly occurred in those patients with a burn area over 70% TBSA.Mortality rate of the cases of MOF was directly proportional to the number of organs involved.The incidence of pulmonary failure was the highest and the highest mortality was attributed to renal failure;MOF in the early stage after burns was mainly induced by burn shock and that in the late stage by burn wound infection.Endogenous infection seemed to be one of the important causes to precipitate the outbreak of postburn MOF.The morphological changes of the functionally failed organs were as followsThere were various degrees of cellular degeneration and necrosis.Or- ganelle changes such as swelling and vacuolization of mitochondria,enlargement of endoplasmic reticulum,gap formation of capillary endothelium etc were seen.Extravascular organ water volume of the functionally failed organs was increased.Stasis and/or hyperemia were found in the heart,the lungs,the liver and the GI,tract,but ischemia in the kidneys.The changes of the.enzyme spectrum of the myocardium,PaO2,RI,IB/DB,and DB were parallel to those of pathomorphology and extravascular organ water volume and they could reflect the severity of organ damages firly well.