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This book describes Organ Failure, Diagnosis and Treatment and Related Diseases
Organ failure is loss of organ function to such a degree that normal homeostasis cannot be sustained without external medical intervention.
It is not a diagnosis.
It can be categorized by the cause, but when the cause is not known, it can also be categorized by whether the onset is chronic or acute.
Multiple organ failure can be linked with sepsis and is often lethal.
Multiple organ failure is the evidence of altered organ function in acutely ill patients such that homeostasis cannot be maintained without intervention.
It normally affects two or more organ systems.
A definite explanation has not been found.
Local and systemic responses are initiated by tissue damage.
1. Respiratory failure is frequent in the initial 72 hours.
Later, one might observe:
2. Liver failure (5–7 days),
3. Gastrointestinal bleeding (10–15 days) and
4. Kidney failure (11–17 days).
1. Medicine overdose - can affect the function of the organ
2. Reactions to prescription medicines - can affect the function of the organ
Some prescription medicines, such as slimming medicines, antibiotics, non-steroidal anti-inflammatory drugs and anticonvulsants, can cause acute organ failure.
3. Reactions to herbal supplements, herbal preparations, plants and plant products
4. Infection of bacteria and viruses – reaction to pathogens can cause sepsis or septic shock.
5. Toxins – damages the tissues of the organ
6. Autoimmune disease – autoimmune antibodies attack the affected organ
7. Ischemia or veno-occlusive disease – poor blood flow reduces oxygen to the organ
a. Primary cancer
b. Metastatic carcinoma
9. Shock – low blood volume and pressure
10. Chronic alcohol abuse - alcoholism
11. Drug toxicity that are related to medicines such as ciprofloxacin, doxycycline, co-amoxiclav, erythromycin, isoniazid, nitrofurantoin, halothane, statins, cyclophosphamide, methotrexate, disulfiram, flutamide, gold and propylthiouracil
12. Metabolic disease.
The doctor will examine the patient for signs of organ failure such as:
1. Leg swelling
2. Distended neck veins
3. Fast or difficult breathing
4. Sounds from fluid buildup in the lungs
5. Swelling of the liver or abdomen or face
6. Uneven or fast heartbeat and abnormal heart sounds
A test for respiratory and heart failure often requires a chest x-ray.
Once the patient is diagnosed with respiratory failure, the doctor will determine the cause of it.
1. An ultrasound is the best test to diagnose, determine the cause of, and monitor the organ failure because it can check on the blood flow through the organ.
2. MRI or CT scan of the organ
3. Nuclear scans of the organ
They can observe at how well the organ is able to function and how much the organ is injured:
Imaging of the head may show cerebral edema.
Laboratory blood tests are done to:
i. Diagnose and monitor organ failure
ii. Identify risks for organ disease
iii. Check for other causes of organ failure, or disorder that may make the organ failure worse
iv. Review for side effects of medicines the patient may be taking
1. Kidneys condition (BUN, creatinine, creatinine clearance, and urinalysis)
2. Full blood count (FBC) for low red blood count or anemia
3. Test for brain natriuretic peptide (BNP)
4. Sodium and potassium levels in the blood
5. Arterial blood gas test
The purposes of organ failure treatment are to:
1. Relieve symptoms and improve quality of life
2. Slow disease progression
Plasmapheresis and Dialysis may be done while waiting for a organ transplant.
TABLE OF CONTENT
Chapter 1 Organ Failure
Chapter 2 Multiple Organ Failure
Chapter 3 Heart Failure
Chapter 4 Respiratory Failure
Chapter 5 Kidney Failure
Chapter 6 Liver Failure
Chapter 7 Coma or Brain Failure
Chapter 8 Gastrointestinal Bleeding