Multiple Organ Dysfunction (MODS) in Sepsis

Sepsis is one of the life-threatening condition affecting many children. A continuum of severity from sepsis to septic shock and MODS exists. The emergence of MODS as a clinical entity is one of the hallmark challenges of the modern era of critical care medicine. The clinical process usually begins with infection, which potentially leads to sepsis and organ dysfunction. Despite advances in pediatric intensive care and the widespread use of protocols and standard guidelines, sepsis remains a leading cause of mortality. Focus shifted from one organ to multiorgan support as these children die of multiorgan dysfunction and not the primary disease. MODS reflects a continuum of dysfunction rather than a dichotomous state of normal function versus failure which is potentially reversible, and the degree of organ dysfunction could change over time. The current consensus criteria of pediatric sepsis based on the concept of SIRS do not play an effective role in identifying clinically hazardous patients. It is strongly desirable that pediatric sepsis should be redefined on the basis of organ dysfunction scoring. This review intends to summarize sepsis and organ dysfunction and discusses potential directions for future research.