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    Organ Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Organ Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Organ Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook141 pages1 hour

    Organ Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    This book describes Organ Failure, Diagnosis and Treatment and Related Diseases
    Organ failure is loss of organ function to such a degree that normal homeostasis cannot be sustained without external medical intervention.
    It is not a diagnosis.
    It can be categorized by the cause, but when the cause is not known, it can also be categorized by whether the onset is chronic or acute.
    Multiple organ failure can be linked with sepsis and is often lethal.
    Multiple organ failure is the evidence of altered organ function in acutely ill patients such that homeostasis cannot be maintained without intervention.
    It normally affects two or more organ systems.
    Causes
    A definite explanation has not been found.
    Local and systemic responses are initiated by tissue damage.
    1. Respiratory failure is frequent in the initial 72 hours.
    Later, one might observe:
    2. Liver failure (5–7 days),
    3. Gastrointestinal bleeding (10–15 days) and
    4. Kidney failure (11–17 days).
    Risk Factors:
    1. Medicine overdose - can affect the function of the organ
    2. Reactions to prescription medicines - can affect the function of the organ
    Some prescription medicines, such as slimming medicines, antibiotics, non-steroidal anti-inflammatory drugs and anticonvulsants, can cause acute organ failure.
    3. Reactions to herbal supplements, herbal preparations, plants and plant products
    4. Infection of bacteria and viruses – reaction to pathogens can cause sepsis or septic shock.
    5. Toxins – damages the tissues of the organ
    6. Autoimmune disease – autoimmune antibodies attack the affected organ
    7. Ischemia or veno-occlusive disease – poor blood flow reduces oxygen to the organ
    8. Neoplasm
    a. Primary cancer
    b. Metastatic carcinoma
    9. Shock – low blood volume and pressure
    10. Chronic alcohol abuse - alcoholism
    11. Drug toxicity that are related to medicines such as ciprofloxacin, doxycycline, co-amoxiclav, erythromycin, isoniazid, nitrofurantoin, halothane, statins, cyclophosphamide, methotrexate, disulfiram, flutamide, gold and propylthiouracil
    12. Metabolic disease.
    Diagnosis
    The doctor will examine the patient for signs of organ failure such as:
    1. Leg swelling
    2. Distended neck veins
    3. Fast or difficult breathing
    4. Sounds from fluid buildup in the lungs
    5. Swelling of the liver or abdomen or face
    6. Uneven or fast heartbeat and abnormal heart sounds
    Chest x-ray
    A test for respiratory and heart failure often requires a chest x-ray.
    Once the patient is diagnosed with respiratory failure, the doctor will determine the cause of it.
    1. An ultrasound is the best test to diagnose, determine the cause of, and monitor the organ failure because it can check on the blood flow through the organ.
    2. MRI or CT scan of the organ
    3. Nuclear scans of the organ
    They can observe at how well the organ is able to function and how much the organ is injured:
    Imaging of the head may show cerebral edema.
    Laboratory blood tests are done to:
    i. Diagnose and monitor organ failure
    ii. Identify risks for organ disease
    iii. Check for other causes of organ failure, or disorder that may make the organ failure worse
    iv. Review for side effects of medicines the patient may be taking
    1. Kidneys condition (BUN, creatinine, creatinine clearance, and urinalysis)
    2. Full blood count (FBC) for low red blood count or anemia
    3. Test for brain natriuretic peptide (BNP)
    4. Sodium and potassium levels in the blood
    5. Arterial blood gas test
    Treatment
    The purposes of organ failure treatment are to:
    1. Relieve symptoms and improve quality of life
    2. Slow disease progression
    Plasmapheresis and Dialysis may be done while waiting for a organ transplant.

    TABLE OF CONTENT
    Introduction
    Chapter 1 Organ Failure
    Chapter 2 Multiple Organ Failure
    Chapter 3 Heart Failure

    LanguageEnglish
    PublisherKenneth Kee
    Release dateMar 28, 2019
    ISBN9780463661314
    Organ Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Organ Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Organ Failure,

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2019 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes Organ Failure, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What You Need to Treat Organ Failure)

      This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog: http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 800 eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical disorders.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Organ Failure

      What is Organ Failure?

      Organ failure is loss of organ function to such a degree that normal homeostasis cannot be sustained without external medical intervention.

      It is not a diagnosis.

      It can be categorized by the cause, but when the cause is not known, it can also be categorized by whether the onset is chronic or acute.

      Multiple organ failure can be linked with sepsis and is often lethal.

      Multiple organ failure is the evidence of altered organ function in acutely ill patients such that homeostasis cannot be maintained without intervention.

      It normally affects two or more organ systems.

      What are the causes of Organ Failure?

      Causes

      A definite explanation has not been found.

      Local and systemic responses are initiated by tissue damage.

      1. Respiratory failure is frequent in the initial 72 hours.

      Later, one might observe:

      2. Liver failure (5–7 days),

      3. Gastrointestinal bleeding (10–15 days) and

      4. Kidney failure (11–17 days).

      Risk Factors:

      1. Medicine overdose - can affect the function of the organ

      2. Reactions to prescription medicines - can affect the function of the organ

      Some prescription medicines, such as slimming medicines, antibiotics, non-steroidal anti-inflammatory drugs and anticonvulsants, can cause acute organ failure.

      3. Reactions to herbal supplements, herbal preparations, plants and plant products

      4. Infection of bacteria and viruses – reaction to pathogens can cause sepsis or septic shock.

      5. Toxins – damages the tissues of the organ

      6. Autoimmune disease – autoimmune antibodies attack the affected organ

      7. Ischemia or veno-occlusive disease – poor blood flow reduces oxygen to the organ

      8. Neoplasm

      a. Primary cancer

      b. Metastatic carcinoma

      9. Shock – low blood volume and pressure

      10. Chronic alcohol abuse - alcoholism

      11. Drug toxicity that are related to medicines such as ciprofloxacin, doxycycline, co-amoxiclav, erythromycin, isoniazid, nitrofurantoin, halothane, statins, cyclophosphamide, methotrexate, disulfiram, flutamide, gold and propylthiouracil

      12. Metabolic disease.

      Pathophysiology

      Gut hypothesis

      The most popular hypothesis to explain organ failure in critically ill patients is the gut hypothesis.

      Due to splanchnic hypo-perfusion and the subsequent mucosal ischemia there are structural changes and alterations in cellular function.

      This results in higher gut permeability, altered immune function of the gut and higher translocation of bacteria.

      Liver dysfunction results in toxins escaping into the systemic circulation and stimulating an immune reaction.

      This results in tissue injury and organ dysfunction.

      Endotoxin macrophage hypothesis

      Gram-negative infections in patients are relatively common hence endotoxins have been advanced as principal mediator in this disorder.

      It is believed that after the initial event cytokines are formed and released.

      The pro-inflammatory mediators are:

      1. Tumor necrosis factor-alpha (TNF-α),

      2. Interleukin-1,

      3. Interleukin-6,

      4. Thromboxane A2,

      5. Prostacyclin,

      6. Platelet activating factor, and

      7. Nitric oxide.

      Tissue hypoxia-microvascular hypothesis

      As a result of macro and micro-vascular changes an inadequate supply of oxygen happens.

      Hypoxemia causes cell death and organ dysfunction

      Mitochondrial DNA hypothesis

      Mitochondrial DNA is the main cause of serious inflammation due to a massive quantity of mitochondrial DNA that flows into the blood stream because of cell death of patients that lived through major trauma.

      Mitochondrial DNA resembles bacterial DNA.

      If bacteria trigger leukocytes, mitochondrial DNA may do the same.

      When attacked with bacteria, the white blood cells or neutrophil granulocytes act like predatory spiders.

      They discharge a net to trap the attackers, then attack them with a deadly oxidative blast, forming neutrophil extra-cellular traps (NETs).

      This leads to a catastrophic immune reaction resulting in multiple organ dysfunction

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