Clinical studies on postburn multiple organ failure: its aetiological factors and monitoring.

This study demonstrated that multiple organ failure (MOF) developed in 16 of 57 severely burned patients (28.1 per cent). When expressed as a percentage of the 590 patients admitted during the same period, the incidence became 2.7 per cent. Fifteen of the 16 MOF cases died, with a mortality of 93.8 per cent. In those patients with TBSA over 80 per cent with inhalation injury, severe shock and systemic infection, the incidence of MOF was significantly higher. Systemic infection and severe shock were the most important complications. These results indicated that the severity of the burn is the prime prerequisite of MOF, while severe shock and systemic infection are secondary but very important factors in the genesis and development of postburn MOF. The circulatory platelet aggregate ratio (CPAR) started to decrease significantly at 12 h postburn, remaining at low levels and declining further at 5-7 days postburn. However the values of the myocardial enzyme spectrum (MES) remained at significantly higher levels, indicating significant and continuous increases of microaggregate formation and the continuous existence of visceral and tissue ischaemia and cellular destruction. Changes of CPAR and MES in MOF patients were directly related to the development of MOF. It is advisable to use CPAR and MES to monitor the possible development of postburn MOF.