Dittmer H, Faist E, Lauterjung K L
Zentralbl Chir. 1983;108(7):385-95.
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.
在4年半的时间里，我院433名多发伤患者中有78人死亡（死亡率18%），其中一半死于脑外伤。仅因呼吸衰竭死亡的有15例，死于多器官功能衰竭的有19例。呼吸衰竭在多器官功能衰竭中至关重要。文中描述了两种多器官功能衰竭类型：一种是严重休克后直接出现的快速型，预后稍好；另一种是由并发脓毒症引起的迟发型。要进一步改善这些结果，有五项要求：1. 精心制定治疗方案：考虑治疗的先后顺序；2. 充分治疗休克；3. 尽早且在必要时持续控制使用呼吸机；4. 避免任何脓毒症发生；5. 密切监测系统功能。
