[Multiple organ failure--the most important complication in polytraumatized patients]

In 4 1/2 years 78 out of 433 polytrauma-patients came to death in our hospital ( = 18%), half of them because of their brain-trauma. 15 fatalities occurred in connection with pulmonary failure only, 19 in multiple organ failure. Pulmonary failure is of central importance in MOF. Two types of MOF are described: the rapid pattern directly following severe shock with slightly better prognosis and a delayed pattern caused by concomitant sepsis. The hope of further improving these results is connected with five demands: 1. an elaborate scheme of treatment: taking the priorities into account; 2. sufficient treatment of shock; 3. controlled use of the respirator as early as possible and as long as necessary; 4. avoiding any sepsis; 5. close monitoring of system function.