Multiple trauma mortality in the critical care setting most often occurs as a result of multi-system organ failure (MSOF). Mortality rates increase exponentially as successive organ systems fail. Although the role of shock in determining patient outcome has been extensively investigated, inflammatory factors and sepsis are becoming increasingly implicated in the development of MSOF. The physiologic effect of these factors on individual organ systems is explained. Signs, symptoms, and key criteria for determining organ system failure also are presented to assist the nurse in recognition and prevention

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