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Epidemiology and Outcomes of Pediatric Multiple Organ Dysfunction Syndrome

Watson, R. Scott MD, MPH1,2; Crow, Sheri S. MD, MSc3; Hartman, Mary E. MD, MPH4; Lacroix, Jacques MD5; Odetola, Folafoluwa O. MD, MPH6

Pediatric Critical Care Medicine: March 2017 - Volume 18 - Issue 3_suppl - p S4-S16
doi: 10.1097/PCC.0000000000001047
MODS Supplement
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Objective: To summarize the epidemiology and outcomes of children with multiple organ dysfunction syndrome as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development multiple organ dysfunction syndrome workshop (March 26–27, 2015).

Data Sources: Literature review, research data, and expert opinion.

Study Selection: Not applicable.

Data Extraction: Moderated by an experienced expert from the field, issues relevant to the epidemiology and outcomes of children with multiple organ dysfunction syndrome were presented, discussed, and debated with a focus on identifying knowledge gaps and research priorities.

Data Synthesis: Summary of presentations and discussion supported and supplemented by the relevant literature.

Conclusions: A full understanding the epidemiology and outcome of multiple organ dysfunction syndrome in children is limited by inconsistent definitions and populations studied. Nonetheless, pediatric multiple organ dysfunction syndrome is common among PICU patients, occurring in up to 57% depending on the population studied; sepsis remains its leading cause. Pediatric multiple organ dysfunction syndrome leads to considerable short-term morbidity and mortality. Long-term outcomes of multiple organ dysfunction syndrome in children have not been well studied; however, studies of adults and children with other critical illnesses suggest that the risk of long-term adverse sequelae is high. Characterization of the long-term outcomes of pediatric multiple organ dysfunction syndrome is crucial to identify opportunities for improved treatment and recovery strategies that will improve the quality of life of critically ill children and their families. The workshop identified important knowledge gaps and research priorities intended to promote the development of standard definitions and the identification of modifiable factors related to its occurrence and outcome.

1Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA.

2Division of Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA.

3Division of Pediatric Critical Care Medicine, Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Mayo Eugenio Litta Children’s Hospital, Rochester, MN.

4Division of Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.

5Division of Pediatric Critical Care Medicine, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada.

6Child Health Evaluation and Research Unit, Division of Pediatric Critical Care, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI.

This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by, the National Institutes of Health, the US Department of Health and Human Services, or the US government.

Dr. Watson received funding from the National Institutes of Health (NIH)/National Institute of Child Health and Human Development, NIH grant review honoraria, Society of Critical Care Medicine (for travel and talks for a Board Review Course), travel for NIH MODS Workshop, and from the CDC (travel for a conference); he received funding via salary from UPMC, University of Pittsburgh, University of Washington, and Seattle Children's Hospital; and he received support for article research from the NIH. Dr. Odetola received funding from the American Board of Pediatrics. The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: Scott.Watson@seattlechildrens.org

Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies