[The multiple organ failure syndrome--its pathophysiology and treatment]

Polyorganic deficiency syndrome (PODS) is a generalized response to the effect of a variety of agents hardly lending itself to control, becoming manifest with rapid proliferation within the body. The issues discussed include: epidemiology with a special reference to panendothelial trauma to pulmonary and other systems with impairment of oxygen utilization by the cells, microcirculation disorders, mediators, ARDS development, disturbed barrier function of the intestinal mucosa, enhanced glutamine consumption with ensuing villous atrophy. Symptoms presented by various organs, treatment consisting in block of stimulation and block of mediators, as well as selective decontamination and adequate diet are also dealt with. Against the background outlined above the prognostic point rating system (the so-called score rating) of PODS with simultaneous application of the APACHE III rating system are evaluated. Age-related factors and number of organs involved are likewise considered.