Development of multiorgan dysfunction (MODS) in case of surgical infection in children

There have been performed investigations in 242 children with surgical sepsis aged from 1 month till 14 years. There were 154 (63,6 %) children aged up to 3 years and 88 (36,4 %) aged from 4 till 14 years. There were observed 80 (33,0 %) patients with “sepsis”, 141 (58,3 %) -with severe sepsis and 21 (8,7 %) - with septic shock. Sepsis was more frequently diagnosed in children up to 3 years of age. There were 50 (39,0 %) such patients. Severe sepsis was diagnosed in 70,5 % patients aged from 4 to 14 years. Septic shock was noticed in 15 (9,7 %) young patient group versus 6 (6,8 %) children aged from 4 till 14 years. The first and most frequently impaired organ in case of sepsis in children is the lungs (86,4 %), dysfunction of other organs in 100 % cases occurs together with acute lungs impairment. The sequence of MOD syndrome development in case of sepsis is as following - respiratory dysfunction - cardiovascular one - encephalopathy - hepatic, kidney, immunology and hematology dysfunctions. The level of procalcitonine and the reduction of the number of circulating monocytes, expressing activation marker HLA-DR+, reflect adequately the intensity of the inflammatory reaction and allow to appoint an adequate start therapy immediately and to conduct objective monitoring during the entire period of hospitalization.