dekomensaation

Dekompensation is the loss of an organ’s ability to maintain homeostasis in the face of chronic disease, leading to an acute deterioration of function. The term is used in medical contexts to describe when the body’s compensatory mechanisms no longer suffice to keep organ performance within normal ranges.

In medicine, decompensation most often appears in relation to the heart, liver, kidneys, and lungs. Decompensated heart failure occurs when the heart can no longer meet circulatory demands, producing shortness of breath, edema, fatigue, and orthopnea. Hepatic decompensation arises in chronic liver disease and is characterized by ascites, jaundice, coagulopathy, hepatic encephalopathy, and sometimes shock. Renal decompensation involves a rapid decline in kidney function in someone with chronic kidney disease, with reduced urine output and metabolic disturbances. Pulmonary decompensation refers to acute respiratory failure resulting from preexisting lung disease or acute injury.

Common triggers include infections, myocardial infarction or arrhythmias, nonadherence to treatment, excess salt or fluid intake, alcohol or substance use, and physiological stress such as surgery or pregnancy. Diagnosis relies on clinical assessment supported by specific investigations: laboratory tests and imaging to evaluate organ function, and disease‑specific markers such as natriuretic peptides for heart failure, liver function tests for hepatic disease, and arterial blood gas analysis for respiratory compromise.

Management focuses on treating the underlying cause, optimizing chronic disease management, and providing supportive care. This may involve diuretics and vasodilators for heart failure, careful fluid management, oxygen therapy or ventilation for respiratory failure, and hospital or intensive care monitoring as needed. Prognosis varies with the underlying condition and the episode’s severity; decompensation often indicates progression of chronic disease and carries a risk of recurrence.