Abstract:
Seizures and epilepsy commonly occur in patients with organ system failure, either as a consequence of trophic effects on cerebral function or of therapies used in such conditions. Acute organ failure results in an abrupt, but often reversible, lowering of seizure threshold, whereas chronic organ failure results in more pervasive and indolent cerebral compromise, often permanently altering both the seizure threshold and the physiologic responses to antiepileptic drugs (AEDs). Failure of an organ system is not typically a sudden, all-or-none phenomenon but occurs in stages with variable susceptibility to seizures as the condition worsens or remits. Although the principles of diagnosis and management of seizures in adult and pediatric patients with a specific organ dysfunction are similar, the underlying etiologies and influences of comorbid conditions differ between adults and children. Adult organ failure often involves multiple systems to different extents and is superimposed on other chronic diseases of adulthood. Pediatric organ failure is usually the result of inherited metabolic disorders, infections, and unique pediatric susceptibilities to metabolic effects of medications (Table 1).Keywords:
Organ system
Etiology
Organ dysfunction
Since its introduction into the medical literature in the 1970s, the term multiple organ dysfunction syndrome (or some variant) has been applied broadly to any patient with >1 concurrent organ dysfunction. However, the epidemiology, mechanisms, time course, and outcomes among children with multiple organ dysfunction vary substantially. We posit that the term pediatric multiple organ dysfunction syndrome (or MODS) should be reserved for patients with a systemic pathologic state resulting from a common mechanism (or mechanisms) that affects numerous organ systems simultaneously. In contrast, children in whom organ injuries are attributable to distinct mechanisms should be considered to have additive organ system dysfunctions but not the syndrome of MODS. Although such differentiation may not always be possible with current scientific knowledge, we make the case for how attempts to differentiate multiple organ dysfunction from other states of additive organ dysfunctions can help to evolve clinical and research priorities in diagnosis, monitoring, and therapy from largely organ-specific to more holistic strategies.
Organ dysfunction
Organ system
Cite
Citations (16)
Organ system
Organ dysfunction
Pathophysiology
Cite
Citations (1)
Organ dysfunction
Organ system
SAPS II
Hepatic dysfunction
SOFA score
Illness severity
Cite
Citations (12)
There are many scores for evaluating multiple organ dysfunction (MODS) which differ appreciably, and this makes it difficult to compare results from different research groups. In addition the variables used to describe organ dysfunction are not always as organ-specific as they should be. In this review we have studied 20 MODS scoring systems to illustrate the variety in variables used to assess organ dysfunction.
Organ dysfunction
Organ system
Cite
Citations (17)
Organ dysfunction
Dysfunctional family
Organ system
Univariate analysis
Cite
Citations (0)
Organ dysfunction
Organ system
Cite
Citations (164)
Organ dysfunction
Dysfunctional family
Organ system
Univariate analysis
Cite
Citations (31)
Department of Anesthesiology and Critical Care Medicine The Children’s Hospital of Philadelphia Philadelphia, PA *See also p. 1705.
Organ dysfunction
Organ system
Cite
Citations (14)
There is as yet no precise definition of the multiple organ failure syndrome, or what is today more appropriately termed the multiple organ dysfunction syndrome (MODS). Clinically MODS can be considered as a sequential or concomitant occurrence of a significant derangement of function in two or more organ systems of the body, against a background of a critical illness. Organ dysfunction may be mild, moderate or severe, and multiple organs may show varying degrees of dysfunction. There is no universally acceptable classification system which defines parameters of organ specific failure. An ACCP/SCCM Consensus Conference which was held in 1991, defined MODS as “the presence of altered function in an acutely ill patient such that homeostasis cannot be maintained without intervention”. 1 This con
Organ dysfunction
Organ system
Cite
Citations (18)
Organ dysfunction
Organ system
Endothelial Dysfunction
Cite
Citations (7)