Multiple Organ Failure
Failure of two or more vital organ systems at once
Quick Facts
- Type: Critical illness syndrome
- Common causes: Sepsis, severe trauma, shock
- Organs affected: Lungs, kidneys, liver, heart, brain, blood
- Seek urgent care: Always a medical emergency requiring intensive care
Overview
Multiple organ failure, also called multiple organ dysfunction syndrome, is a critical condition in which two or more of the body's vital organ systems stop working properly at the same time. It is not a single disease but the end result of a severe insult to the body, such as overwhelming infection, major trauma, or prolonged shock.
When one organ fails, it places stress on others, and a damaging chain reaction can spread through the body. Multiple organ failure is one of the most serious conditions treated in intensive care and is a leading cause of death in critically ill patients. Survival depends on rapidly treating the underlying cause and supporting each failing organ.
Symptoms
Signs reflect which organs are failing and are usually seen in someone who is already seriously ill. They may include:
- Lungs: Severe shortness of breath and low oxygen levels
- Kidneys: Producing little or no urine, fluid buildup
- Liver: Yellowing of the skin and eyes (jaundice), confusion
- Heart and circulation: Very low blood pressure, rapid or irregular heartbeat
- Brain: Confusion, drowsiness, or unresponsiveness
- Blood: Abnormal bleeding or clotting
The person often appears very weak, has an abnormal temperature, and may slip into unconsciousness. This is always a life-threatening emergency.
Causes
Multiple organ failure develops when a severe stress overwhelms the body's ability to keep organs supplied with oxygen and to control inflammation. Common triggers include:
- Sepsis: A dangerous, body-wide response to infection, the most common cause.
- Severe trauma: Major injuries, burns, or crush injuries.
- Shock: Dangerously low blood pressure from blood loss, heart failure, or severe allergic reactions.
- Severe pancreatitis or other intense inflammation.
- Major surgery complications.
- Poisoning or drug overdose.
Risk Factors
- Severe infection or sepsis
- Major trauma, burns, or extensive surgery
- Older age
- Pre-existing chronic illness such as heart, kidney, liver, or lung disease
- A weakened immune system
- Delay in treating the underlying cause
Diagnosis
Diagnosis is made in the hospital, usually in an intensive care unit, by tracking the function of each organ system:
- Blood tests: To measure kidney function, liver function, blood counts, clotting, oxygen levels, and markers of infection.
- Blood pressure and heart monitoring.
- Urine output monitoring to assess the kidneys.
- Imaging and cultures to find the source of infection or injury.
Doctors use scoring systems to track how many organs are affected and how severely, which helps guide treatment and gauge the situation.
Treatment
Treatment takes place in an intensive care unit and has two goals: fix the underlying cause and support the failing organs while the body recovers.
- Treat the cause: Antibiotics and source control for infection, surgery for trauma, or removal of a toxin.
- Breathing support: Oxygen or a ventilator for failing lungs.
- Circulatory support: Intravenous fluids and medications to raise blood pressure.
- Kidney support: Dialysis when the kidneys fail.
- Other support: Blood products, nutrition, and careful monitoring of every organ system.
Recovery can be slow, and some survivors have lasting effects, but supporting organs can give the body time to heal when the cause is treated.
Prevention
- Seek prompt treatment for serious infections before they progress to sepsis
- Manage chronic conditions such as diabetes, heart, kidney, and liver disease
- Follow up closely after major surgery and watch for warning signs
- Recognize early signs of sepsis or shock and seek emergency care quickly
- Stay up to date on recommended vaccinations
When to See a Doctor
Multiple organ failure is always a medical emergency, and it usually develops in someone who is already critically ill. Call emergency services immediately if a person shows signs of severe illness such as:
- Confusion, extreme drowsiness, or unresponsiveness
- Severe difficulty breathing
- Very low blood pressure, cold or mottled skin, and a racing heartbeat
- Producing little or no urine
- Signs of severe infection with high or very low body temperature
Early recognition and treatment of conditions like sepsis can prevent organ failure from developing.
Frequently Asked Questions
What is the most common cause of multiple organ failure?
Sepsis, the body's overwhelming response to infection, is the most common cause. Other major triggers include severe trauma, burns, prolonged shock, and severe pancreatitis. In each case the body cannot keep organs adequately supplied with oxygen.
Can a person recover from multiple organ failure?
Recovery is possible, especially when the underlying cause is treated early and organ support is started promptly in intensive care. However, it is a very serious condition, and some survivors have lasting effects. The chance of recovery depends on the cause and how many organs are affected.
How is multiple organ failure treated?
Treatment occurs in intensive care and combines fixing the underlying cause, such as antibiotics for infection or surgery for trauma, with supporting each failing organ. Support may include a ventilator, dialysis, intravenous fluids, and blood-pressure medications.
How can multiple organ failure be prevented?
The best prevention is treating serious infections, injuries, and shock early before they escalate. Managing chronic illnesses, recognizing the early signs of sepsis, and seeking emergency care quickly all reduce the risk of organs beginning to fail.
References
- MedlinePlus, U.S. National Library of Medicine. Sepsis and critical illness.
- National Institute of General Medical Sciences (NIGMS). Sepsis information.
- Centers for Disease Control and Prevention (CDC). Sepsis.
- Mayo Clinic. Sepsis — Symptoms and causes.