Published online Mar 25, 1996. doi: 10.3748/wjg.v2.i1.6
Revised: February 2, 1996
Accepted: February 16, 1996
Published online: March 25, 1996
AIM: To report 15 cases of abdominal-surgical multiple organ failure (MOF) treated successfully by a new combined therapy using four high doses in large volume and one nutritional support (FHDOS), consisting of one short period high dose of anisodaminum in a large volume, followed by one short period high dose of dexamethasone in a large volume, one high dose of disinfectant antibiotics in a large volume and one high dose washing liquor in a large volume to the abdominal cavity, and finally by applying support of nutrition metabolism.
METHODS: The study group consisted of 15 patients (10 women and 5 men; average age: 42.7) who were hospitalized in our hospital. All patients were given FHDOS as follows. First, a short period of high doses of anisodaminum in large volume delivered via intravenous injection of 40 mg once and with an optional 40 mg added 30 min later according to condition; the total amount may reach 120-240 mg a day, or intravenous injection of 40 mg every 15 min until the condition comes under control. Second, a short period of high doses of dexamethasone in large volume delivered via intravenous injection of 100-200 mg once; this remedy could be continued for 1-3 d and the amount could be decreased according to condition. Third, high doses of disinfectant antibiotics in large volume with select use of antibiotics according to clinical condition of Gram staining status; it was necessary to repeatedly culture the bacteria and make adjustments according to the result and status of drug-resistance to prevent dual infections from occurring. Fourth, high doses of washing liquor (normal saline at 6000-8000 mL to wash the abdominal cavity) in large volume. Finally, one full support of nutrition metabolism.
RESULTS: All the patients treated by FHDOS survived after the rescue treatment without any complication.
CONCLUSION: MOF should be prevented, if possible, by stopping or controlling the injury, removing as much necrotic tissue as possible, improving blood flow and oxygen consumption, supporting metabolism, and preventing infection or by initiating treatment early and adequately. FHDOS is a combined therapy and plays a key role in treating MOF.