Multiple organ dysfunction syndrome (MODS) has been studied in sepsis, trauma or abdominal surgery patients, but not following cardiac surgery. The aim of this study was to investigate the incidence, etiology and risk factors of MODS and the importance of systemic inflammatory response syndrome (SIRS) in the pathogenesis of MODS after cardiac surgery. We performed a retrospective clinical study of cardiac surgical patients operated in 2004 – 2006, investigating the importance of sex, age, type of surgery, comorbidities, cardiopulmonary bypass time, tissue hypoperfusion due to low cardiac output in the development of MODS. We performed also a prospective study to demonstrate the importance of SIRS in the etiology of MODS. During the studied period MODS appeared in 131 patients (7%), more frequent in women, elderly, after complex surgical interventions, in patients with low cardiac output (84%), after sepsis (16%). The incidence of MODS was significantly higher in patients with SIRS, which in turn was more severe in patients with prolonged cardiopulmonary bypass and low cardiac output. The MODS after cardiac surgery is caused especially by tissue hypoperfusion due to low cardiac output and SIRS induced by cardiopulmonary bypass.
Keywords: multiple organ dysfunction syndrome, systemic inflammatory response syndrome, cardiac surgery, cardiopulmonary bypass