Jurnal Komplikasi Anestesi
Vol 13 No 3 (2026)

When “Adequate” MAP Is Not Enough: Underresuscitation as a Driver of Multiple Organ Dysfunction Syndrome in Polytrauma

Vizzi Alvi Fitrah Nasution (Faculty of Medicine Universitas Indonesia Jakarta)
Muhammad Imam Mulia (Faculty of Medicine Universitas Indonesia Jakarta)
Muhammad Azhari Taufik (Faculty of Medicine Universitas Indonesia Jakarta)



Article Info

Publish Date
11 Aug 2026

Abstract

Case: Male, 68 years old, with a history of coronary heart disease and stroke, had shock due to kidney trauma, tension pneumothorax, hemothorax, multiple rib fractures, complete left radius fracture, and right frontal laceration following a traffic accident while driving a car. The patient underwent fluid resuscitation, placed water seal drainage (WSD), and administered dobutamine and norepinephrine via central access in the emergency department. The patient was then transferred to the high care unit (HCU). After 31 hours of treatment, the patient experienced multiple organ dysfunction syndrome (MODS), then treated in the intensive care unit (ICU) on mechanical ventilation. During treatment in the ICU, the patient underwent continuous renal replacement therapy (CRRT) for 48 hours. There were clinical improvements during CRRT, but his condition deteriorated after CRRT terminated. He died on the fifth day. Discussion: Trauma is the main preventable cause of morbidity and mortality in adults. Sepsis can increase the risk of mortality in trauma cases. Insufficient identification of shock etiology and lack of follow-up in this patient led to suboptimal resuscitation up to MODS and death. Mechanical ventilation should be performed during initial resuscitation to reduce oxygen consumption.

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Journal Info

Abbrev

jka

Publisher

Subject

Medicine & Pharmacology

Description

JURNAL KOMPLIKASI ANESTESI (e-ISSN 2354-6514) is a scientific and original journal which published as a forum for various scientific articles including research, literature reviews, case reports and recent book reviews. The presence of this journal, it is hoped that it can provide input of knowledge ...