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What is sepsis? (SIRS,MODS explained)

Sepsis is a clinical syndrome which complicates severe infection. In sepsis there is cardinal signs of inflammation that is vasodilation, leukocyte accumulation, increased microvascular permeability. This signs are seen in tissues that are remote from the infection.

Systemic inflammatory response syndrome (SIRS) is a similar clinical syndrome that is seen in association with noninfectious insult such as  acute pancreatitis, pulmonary contusion.

What is MODS ?
The basic abnormality in sepsis and SIRS is dysregulation of the inflammatory response there may be a massive and uncontrolled release of proinflammatory mediators which initiates a chain of events that lead to widespread tissue injury. This will lead to multiple organ dysfunction syndrome (MODS), which results in  high mortality associated with these syndromes.
Multiple organ dysfunction syndrome is the end of the severity of illness spectrum of both SIRS and sepsis. MODS is classified as primary or secondary.

Primary MODS
Following are the features of Primary MODS.

  1. Primary MODS is the result of a well-defined insult.
  2. In this condition organ dysfunction occurs early.
  3. The organ dysfunction may be directly due to the insult itself (eg, renal dysfunction due to rhabdomyolysis).
Secondary MODS 
In this situation the  organ failure is not directly due to the insult itself, but occur as a  consequence of the host’s response (eg, acute respiratory distress syndrome in patients with pancreatitis)
The progressive abnormalities of the certain organ-specific parameters are used to diagnose MODS They are  given below

  1. PaO 2 /FiO 2 ratio.
  2. Platelet count.
  3. Serum bilirubin.
  4. Serum creatinine (or urine output).
  5. Glasgow coma score.
  6. Hypotension.