Multiple organ failure (MOF) syndrome, also known as multiple organ
dysfunction syndrome (MODS) represents a common but complex problem in
critically ill patients in neonatal intensive care unit (NICU) centers,
and a major cause of morbidity and mortality in newborns. MOF is
considered the result of an inappropriate generalized inflammatory
response of the newborn to a variety of acute insults. This study was
aimed at analyzing, at histology, multiple organ pathological changes in
two newborns admitted to the NICU center of our University Hospital, who
showed a progressive clinical picture of MOF, in order to verify the
pathological changes of vascular structures and of endothelial cells in
the different organs affected by MOF. All the samples obtained at
autopsy for histological examination showed specific organ pathological
changes, especially related to modifications in vascular structures and,
in particular, in endothelial cells. The most interesting findings were
found in the intestinal barrier, in the lower respiratory tract and in
the endothelial barrier. The loss of the gut barrier could allow the
passage into the blood of microbial factors that could trigger the
production of tumor necrosis factor alpha (TNF alpha) leading to
endothelial damage. Our preliminary study underlines the principal role
probably played by intestinal and vascular changes in the origin of MOF
in newborns