Medically Complex Care

When the inflammation from a severe infection or injury causes dysfunction in two or more organ systems, this is called multiple organ system failure. Multiple organ dysfunction syndrome can affect any or all of six organ systems: respiratory (lungs), cardiovascular (heart), renal (kidneys), hepatic (liver), neurologic (brain) and hematologic (blood).

Respiratory: Respiratory failure occurs when the lungs are damaged as a result of injury, infection, or surgical complications and the body either doesn’t get enough oxygen or builds up too much carbon dioxide.

Cardiovascular: Heart failure can occur when the heart muscle is too weak or stiff to pump blood properly. Heart failure can lead to both kidney and liver damage, as the blood flowing from the heart to the kidneys may decrease, and the liver may experience pressure from fluid buildup.

Renal: Acute renal failure happens when the kidneys are not able to filter waste from the blood. When the kidneys lose this ability, dangerous levels of waste can accumulate, and the blood’s chemistry may become unbalanced.

Hepatic: Liver failure occurs when large parts of the liver become damaged beyond repair and the liver can no longer function.

Neurologic: Brain injuries can be caused by physical trauma, or by non-traumatic medical factors, such as meningitis, tumors, aneurysms, or strokes. Because the brain controls all bodily functions, injury to this organ has wide-reaching effects.

Hematologic: Bleeding in the gastrointestinal tract or breaks in the skin are common when someone is experiencing multiple organ failure. This can be very difficult to control or stop.

Currently, there is no drug or therapy that can reverse organ failure; however, organ function can recover to some degree. Mechanical ventilation and dialysis are two treatments that can support specific organ functions. 

Diabetes mellitus is a group of diseases that affect a person’s ability to process blood glucose (sugar). Normally, a person’s pancreas produces insulin to help their body store and use the sugar from the food they eat, but when a person has diabetes, their pancreas releases little or no insulin, or their body does not react to the insulin being produced. This can result in a buildup of sugar in the blood and potentially dangerous complications like stroke or heart disease.

If a person has diabetes and irregular or high blood sugar for a long period of time, complications may eventually become disabling or possibly even life-threatening. Some of these complications include cardiovascular disease, peripheral neuropathy or nerve damage, and kidney damage.  

COPD stands for chronic obstructive pulmonary disease. It is a disease of the lungs that can manifest in two ways: chronic bronchitis, which is characterized by a long-term cough with mucus; or emphysema, which damages the lungs over an extended period of time. In addition to breathing problems and a mucus-producing cough, COPD is associated with other health problems including heart failure, pneumonia, and lung cancer.  

Pulmonary edema is a medical condition caused by excess fluid in the lungs, preventing the exchange of oxygen and carbon dioxide. Cardiogenic pulmonary edema is caused by congestive heart failure while non-cardiogenic pulmonary edema is typically caused by injuries to the lungs, brain or central nervous system. Complications from pulmonary edema may include acute respiratory distress syndrome, cardiac arrhythmia, pleural effusion, sepsis, and pneumonia. 

A ventilator, or respirator, is a machine that helps patients breathe. Connection to a ventilator occurs through either a mask or through a tracheostomy, a surgical procedure to open a hole in the neck. The process of breathing through mechanical ventilation is not the same as how we normally breathe. A ventilator pushes air into a patient’s lungs. When the lungs are full, the vent stops pushing and air leaves the lungs on its own.

Dialysis is a treatment that eliminates toxins and excess fluid from the body when the kidneys have failed. In the process of hemodialysis, a patient’s blood enters a dialyzer machine, is cleaned over the course of 3-5 hours, and then is returned to the patient. Peritoneal dialysis uses a solution that is sent into a patient’s abdomen (peritoneal cavity) where it absorbs waste and then is released into a bag.