Abstract

CAPELLI, Carola; SALAFIA, Daniela; BELLANI, Patricia  and  DE SARASQUETA, Pedro. Síndrome de disfunción múltiple de órganos en neonatología: Comparación de dos períodos. Arch. argent. pediatr. [online]. 2005, vol.103, n.4, pp.317-322. ISSN 0325-0075.

Introduction. Multiple organ system dysfunction (MOSD) syndrome is an important cause of morbidity and mortality in pediatric and neonatal intensive care units. We studied the clinical course and the outcome of MOSD in neonates admitted to a neonatal intensive care unit. Our objective was to analyze the changes observed in the MOSD in two different periods (1997-2002). Population, material and methods. We prospectively evaluated two groups of 100 consecutive neonates admitted to the neonatal intensive care at the "Hospital Prof. Dr. J. P. Garrahan" between July 1st and December 31er 1997 (first period) and December 1st - July 31st 2002 (second period). Organ system dysfunction was analyzed regarding its global rate, causes, presenting time, severity, compromise of different organs and intervening factors in its final outcome. We defined multiple organ system dysfunction as the failure of two or more systems or organs during a period longer than 24 hours. The dysfunction criteria for each organ were defined as in a previous study in order to compare both periods. Results. We observed an increase in frequency (n= 60) but a lower mortality rate in the second period (15%) (p <0.05). There was a higher frequency of progression to organ dysfunction in congenital cardiac and digestive defects in the second period. A similar pattern of high frequency of progression and presentation of organ dysfunction after the admission was observed in both periods. Mortality was related to the number of organ or systems affected. Conclusions. There were important changes in multiple organ dysfunction in both periods. The frequency was higher and the mortality was lower in the second period. Both periods showed a high frequency of progression or presentation of organ systemic dysfunction after admission. Mortality was related to the number of organs and systems affected. A change in the definition of neonatal multiple organ systemic disfunction is proposed due to a probable overdiagnosis with the inclusion of congenital defects before treatment.

Keywords : Multiple organ system dysfunction syndrome; Neonatal mortality; Neonatal intensive care.

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