Consequences of trauma: systemic inflammation and multiple organ dysfunction

Critically injured patients are at risk for systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). MODS is a clinical syndrome of progressive physiologic dysfunction of organ systems. Trauma patients are at high risk for SIRS/MODS because of circulatory shock with tissue hypoxemia, tissue injury, and infection. Organ dysfunction may be a direct consequence of an insult (primary MODS) or may manifest latently (secondary MODS) and involves organs not initially injured. Management of SIRS/secondary MODS requires control/elimination of the source of inflammation, maintenance of tissue oxygenation, nutritional/metabolic support, support for individual organs, and effective pain control.