[Reappraisal of clinical pictures of multiple organ failure]

Disseminated intravascular coagulation syndrome (DIC) and also multiple organ failure (MOF) still remain principal causes of death after major surgery or trauma. The author tried to reappraise the clinical features of MOF, especially with the special reference to DIC. One hundred and thirty three cases with MOF were collected from eight university hospitals. The results of analysis of these cases were as follows. 1. Criteria in the diagnosis MOF and also DIC remain controversial among each institute. 2. Severity in the impairment of organ functions also so different among various kinds of vital organs in the present conventional criteria in the diagnosis of MOF. 3. The author proposes a new criterion in the diagnosis of MOF, including serum total bilirubin level above 10 mg/dl or serum transaminase level above 200 K.U. as to the sign of impaired liver function, and BUN above 75 mg/dl or serum creatinin level above 5 mg/dl to indicate an impaired renal function. More precise and close relation between the numbers of impaired organs and the therapeutic results might to obtained by our new criterion. 4. Analysis of these collected cases with MOF also indicated that MOF associated with DIC might be considered to have more grave and serious prognosis, although 58 cases with MOF showed no sign and symptoms of DIC among 129 cases, diagnosed by Tamakuma 's criterion.