MODS Case Studies

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What is MODS? Multiple organ dysfunction syndrome. Progressive failure of two or more organ systems, resulting from acute, severe illnesses or injuries (sepsis, systemic inflammatory response, trauma, burns) and mediated by the body 's inability to sufficiently activate its defense mechanisms (Saunders, 2007).

After reviewing W.A.’s presentation, what organ systems do you suspect are involved and why? Heart, kidneys, bladder
Heart: The BNP level in W.A.’s blood was above normal. A high value of BNP in the blood may show early heart failure in people on kidney dialysis. She also has +2 pitting edema and Crackles in bilateral lower lobes and shortness of breath. As heart failure gets worse, fluid starts to build up in your lungs and other
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Urinalysis: Dark yellow and cloudy, protein 28 mg/dL, positive for casts, positive for red blood cells and white blood cells, positive for glucose and ketones.

What do you think is the origin of W.A.’s septicemia?
Septicemia is an infection of the blood, also known as bacteremia or blood poisoning. The most common infections that lead to septicemia are: urinary tract infections, lung infections, such as pneumonia, kidney infections, and infections in the abdominal area. I believe the origin of W.A.’s septicemia is her kidneys.

What additional tests would you anticipate for W.A.?
Ultrasound/CT Scan- To get a picture of the kidneys and urinary system. This will show the size of the kidneys whether or not there is kidney stones, tumors or cysts present.
Biopsy- To remove a tiny piece of kidney for evaluation. What kind of kidney damage is happening?
Urine output measurements- The amount of urine you excrete in a day may help your doctor determine the cause of your kidney failure
Chest XRAY- This will show the size of the heart and whether there is fluid build-up around the heart and lungs.
Echocardiogram- This will show a graphic outline of the hearts movement.
Doppler Ultrasound- To evaluate blood flow across the hearts
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