[Burns complicated by multiple organ failure--report of 41 cases].

UNLABELLED

41 patients with extensive burns (23 male, 18 female, age 1 9/12-84 years) complicated by SMOF were studied. Fourteen cases with MSOF (34.1%) happened in shock stage and 27 cases (65.9%) in infectious stage. Among them, 37 patients were associated with inhalation injury. There were two organs affected in 29 cases, three organs in 6 cases and four organs in 4 cases. Pulmonary function failures were found in 29 cases, cardiac failures in 21 cases, gastrointestinal function failures in 19 cases, renal function failures in 16 cases, liver function failures in 9 cases and coagulation function failures in 4 cases. Thirty cases died and 11 cases survived.

DISCUSSION

1. Shock was the principal cause to result in MSOF after burn injury. Of the 41 cases, 36 cases expressed a certain extent of shock in early stage. Metabolic disorder might occur in case that hypovolemic shock could not be corrected in two to four hours after injury. The destruction of the ultrastructure of the cells and the harmful effects of the oxygen free radical would finally result in MSOF. 2. Burn infection was the basis for developing MSOF. 27 cases were found that sepsis is the cause of MSOF. Injury of tissue cells caused by the necrotic tissue of the wound and the endotoxin produced by bacterial infection would lead to MSOF. 3. The pre-existing disease of the organs prior to burn injury could directly lead to the failure of the related organs. 4. The measures to prevent MSOF included: to correct hypovolemic shock as soon as possible, to control local and systemic infections effectively, to strengthen whole body supportive therapy.