[Multiple organ failure after severe burns]

Abstract

36 cases with multiple organ failure (MOF) in a group of 178 severe burn injury patients during 1969-1989 were observed in our department. The rate of occurrence of MOF in this group was 20.2% (36/178). 25 cases out of these 36 patients died, and the mortality rate was 69.5% (25/36). In 10 cases 2 organs were involved, and two patients died; 3 organs were involved in 13 cases and nine of them died; more than 4 organs were affected in 13 cases and all of them died. The relationship between MOF and shock, inhalation injury as well as septicemia was discussed. Although there were many factors which could induce postburn multiple organ failure (PBMOF), the severity of the injury was the most fundamental inducing factor. The severer the burn injury, the higher the morbidity and mortality of PBMOF. Both shock and inhalation injury were important inducing factors in early PBMOF. Wound sepsis and septicemia were major inducing factors in delayed PBMOF. Majority of the delayed PBMOF took place during septicemia. In consideration of the high mortality of PBMOF and lack of effective treatment at present, it is extremely important to prevent severe burn injury patients from developing PBMOF. The measures to prevent PBMOF included: to correct shock adequately as soon as possible, to select the optimal time and appropriate extent of escharotomy and skin grafting, to try our best to ensure complete or near complete take of skin grafts, and to strengthen systemic metabolic support.