MODS was presumed to be caused by various pathophysiologic conditions. The epidemiology and pathophysiology include infectious mode 1 and 2, 1-hit and 2-hit models, dysfunctional inflammatory response, impaired oxygen consumption, xanthine oxidase-dependent reactive oxygen metabolites, neutrophil chemotaxis, polymorphonuclear neutrophil adherence, gut hypothesis, and immunosuppression from blood transfusion.

Unfortunately, once MODS develops, our current understanding of the inflammatory response is inadequate to manage the condition. Our only recourse is to control the source of inflammation, support the failing organs, provide nutritional support, and prevent further iatrogenic injury.