J.Jpn. Surg. Soc.. 83(9): 1118-1122, 1982

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Report on the annual meeting

THE MANAGEMENT OF THE MULTIPLE ORGAN FAILURE FOLLOWING OPERATION OF DIGESTIVE SYSTEM
－SEVERE POSTOPERATIVE INFECTION RELAED TO MULTIPLE ORGAN FAILURE

During past 5 years, 1695 cases of the operation of digestive system have been carried out in our department. Eighty-five cases had complication of severe postoperative infection and 29 cases showed multiple organ failure. Tuenty-nine cases were reviewed in this study. The results were as follows:
1) The prognosis was quite poor, mean mortality rate was 75.9%, 70% mortality rate was found in cases of 2 organ failure, 80% in 3 organ failure. While all the cases of 4 organ failure died.
2) All of them were managed with hyperalimentation. Hyperglycemia was occurred in 19 cases among them, 15 cases (78.9%) died.
3) To control hyperglycemia, the dose of insulin should be regulated with the ratio of 1 unit to 1gr. of daily urinesugar or 1 unit to 3-5gr. iv given sugar.
4) During the acute phase of hyperglycemia, insulin should be given by intravenous, or continuous subcutaneous route during the first 6 hours. While during the steady phase, the continous subcutaneous route of given insulin seems to be very suitable way to control the blood sugar along the description mentioned above.

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