[The multiple organ failure syndrome (MOFS) and septic states]

The multiple organic failure syndrome (MOFS or MOF) is the result of a hyperergic and chaotic activation of the unspecific immune (inflammatory) system. It may be elicited, either as a consequence of hypodynamic shock phenomena with initial tissular lesions caused by a diseased peripheral vascular bed, characteristic of states of shock, or as the result of an inflammatory aseptic or septic focus occurring in the process of transformation of tissular territories diseased under the action of various factors (traumatic, thermic, immune etc.). The local inflammatory process sets in motion a series of elements of the immune apparatus, such as: polynuclear neutrophilic leucocytes, macrophages, complement, which lead, when they begin to exert an hyperergic action, to the cascade activation of these elements also outside the focus of lesion, generating disseminated lesions at the level of organs and systems of organs. The lesions have an aleatory character and affect variously organs and territories, leading finally to insufficiency phenomena with clinical expression: renal failure, pulmonary failure, encephalopathy, shock digestive tract, intravascular disseminated coagulation, state of shock initially hyperdynamic and afterwards hypodynamic, metabolic disturbances etc. The specific manifestations, the symptomatology, the therapy and the prognosis of the syndrome are described.