ABSTRACT
Organ failure is regrettably a common result of trauma in adult populations accounting for a significant proportion of all adult trauma deaths. The trauma literature usually divides mortality into three categories, with the ‘‘third wave’’ representing those patients dying from multiple organ system failure and sepsis. Plotting pediatric trauma mortality against time from injury typically produces a bimodal curve (1,2). The primary curve peaks immediately after the accident and represents death at the scene or in transit to the emergency facility. The second peak occurs around three or four days later and is usually associated with head injury (3-5). Organ failure as described in relation to trauma in adults is uncommon in children. Although sepsis and multiple organ system failure are common in pediatric intensive care units , only 1.5-5% of such cases result from trauma (6-9).
