Wed20October0612PM 5

Which of the following help to prevent the development of multiple organ dysfunction syndrome (MODS) in trauma patients?

True / False

Delaying fracture fixation until the patient has been haemodynamically stable for 48 hours Correct

Avoiding the use of propofol for ICU sedation Incorrect answer selected

Selective decontamination of the digestive tract Correct

Early nasogastric feeding Correct

Long term use of broad spectrum antibiotics Correct

Explanation

Multiple organ dysfunction syndrome (MODS) is defined as 'the presence of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention'. It is a frequent complication of the systemic inflammatory response syndrome (SIRS) and sepsis.

Enteral feeding via a gastric tube should be started as soon as possible in all trauma patients.

In the absence of enteral nutrition the gut mucosa atrophies and bacteria may 'translocate', which is thought to be the cause of sepsis and MODS.

Selective decontamination of the digestive tract (SDD) may reduce the incidence of nosocomial infection and evidence to suggest it reduces the incidence of MODS. The use of broad spectrum antibiotics will merely encourage the development of resistant bacteria.

Fractures should be stabilised as soon as possible.

Using propofol for long term sedation on the ICU is no longer popular, however this is not associated with the development of MODS.

Reference:

Silvestri L, van Saene H.K., Zandstra DF. et al. Impact of selective decontamination of the digestive tract on multiple organ dysfunction syndrome: Systematic review of randomized controlled trials. Crit Care Med. 2010;38:1370-1376.

Answer Statistics

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Average score: 75.32%

Times answered: 252