Smail N, Messiah A, Edouard A, Descorps-Declère A, Duranteau J, Vigué B, Mimoz O, Samii K
Département d'Anesthésie-Réanimation, Université Paris-Sud, Hôpital de Bicêtre, Le Kremlin, France.
Intensive Care Med. 1995 Oct;21(10):813-6. doi: 10.1007/BF01700964.
To evaluate the role of infection and systemic inflammatory response syndrome (SIRS) on the occurrence of early posttraumatic MODS.
Retrospective study.
University Teaching Hospital ICU.
163 consecutive patients hospitalized for more than 48 hours following severe trauma.
The patients were classified into two groups in respect to the existence of MODS at day 2. There was 27 patients in the MODS group and 136 patients in the no MODS group. The two groups were similar with respect to age, sex ratio and Simplified Acute Physiology Score. The MODS group had a higher mortality (52 versus 7%), Injury Severity Score (45 +/- 14 versus 31 +/- 13), hypovolemic shock rate (74 versus 30%), massive volume replacement rate (59 versus 6%) and SIRS rate (81 versus 54%) than the no MODS group (P < 0.05). The rate of infection was similarly low in the MODS and no MODS group (4 versus 6% respectively).
Early MODS is often associated with hypotension and massive volume administration but very rarely with infection, despite the high rate of SIRS.
评估感染及全身炎症反应综合征（SIRS）在创伤后早期多器官功能障碍综合征（MODS）发生中的作用。
回顾性研究。
大学教学医院重症监护病房。
163例因严重创伤住院超过48小时的连续患者。
根据第2天是否存在MODS将患者分为两组。MODS组有27例患者，非MODS组有136例患者。两组在年龄、性别比和简化急性生理学评分方面相似。与非MODS组相比，MODS组的死亡率更高（52%对7%）、损伤严重度评分更高（45±14对31±13）、低血容量休克发生率更高（74%对30%）、大量液体复苏率更高（59%对6%）以及SIRS发生率更高（81%对54%）（P<0.05）。MODS组和非MODS组的感染率同样较低（分别为4%和6%）。
尽管SIRS发生率很高，但早期MODS常与低血压和大量液体输注相关，而与感染关系不大。
