Abstract
The etiology of multiple organ failure (MOF) remains inadequately understood and it remains a significant cause of mortality in thermally injured patients. Many factors may drive or lead to MOF, such as relative immunosuppression and infection from the thermal injury itself, further immunosuppression from multiple blood transfusions required by excisional debridement, an impaired gastrointestinal barrier, hypoperfusion, and infection; but ultimately MOF appears to be a result of an uncontrolled inflammatory state. An appropriate burn resuscitation coupled with diligent care in the intensive care unit can decrease the incidence of MOF, but have not been able to fully eradicate it. Ongoing research in nutritional, non-specific, and specific immunomodulation holds promise of potential improvement in our ability to care for critically ill burn patients and scoring systems allow us to better predict patients at greatest risk of MOF and death.