J.Jpn. Surg. Soc.. 83(9): 1123-1126, 1982

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Report on the annual meeting

A STUDY ON THE CLINICAL ASPECTS OF POSTOPERATIVE RESPIRATORY FAILURE AND MULTIPLE ORGAN FAILURE

Clinical aspects of 48 patients with hypoxia despite oxygen inspiration respiratory failure, was studied. Seventy five percent of the patients had malignant tumors such as gastric cancer, esophageal cancer, colonic cancer, pancreatic cancer, and etc. All patients underwent various major surgery of the abdominal viscera. Severe infections such as peritonitis, pleuritis, sepsis and pneumonia were found in 35 patients at the onset of respiratory failure, and shock in 22 patients before or after respiratory failure. Of these 22 patients, shock preceded respiratory failure in 17 Of the patients with respiratory failure, there were hepatic failure in 18, renal failure in 16, gastrointestinal bleeding in 5 and cerebral damage in 3. In the patients with sepsis or shock, rate of the multiple organ failure was twofold higher than in the patients without them. Overall mortality rate of respiratory failure was 77.2%, however, it was reduced to 35.7% in the patients without sepsis. Analysis of two periods revealed that the mortality rate of 86.4% in the patients treated from 1976 to 1978 fell to 66.9% in the patients treated after 1979, and survival time of dead patients was prolonged from 11.3 days to 33.1 days in the recent period.
The results suggest that sepsis and shock are the contributory etiologic factor of respiratory and other organ failure, and the improvement of the result of treatment should not be expected without the control of infection.

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