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Specific Etiologies Associated With the Multiple Organ Dysfunction Syndrome in Children: Part 2

Upperman, Jeffrey S. MD; Bucuvalas, John C. MD; Williams, Felicia N. MD; Cairns, Bruce A. MD; Cox, Charles S. Jr. MD; Doctor, Allan MD; Tamburro, Robert F. MD, MSc

doi: 10.1097/PCC.0000000000001051
MODS Supplement
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Objective: To describe a number of conditions and therapies associated with multiple organ dysfunction syndrome presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Multiple Organ Dysfunction Workshop (March 26–27, 2015). In addition, the relationship between burn injuries and multiple organ dysfunction syndrome is also included although it was not discussed at the workshop.

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

Study Selection: Not applicable.

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

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

Conclusions: Sepsis and trauma are the two conditions most commonly associated with multiple organ dysfunction syndrome both in children and adults. However, many other pathophysiologic processes may result in multiple organ dysfunction syndrome. In this article, we discuss conditions such as liver failure and pancreatitis, pathophysiologic processes such as ischemia and hypoxia, and injuries such as trauma and burns. Additionally, therapeutic interventions such as medications, blood transfusions, transplantation may also precipitate and contribute to multiple organ dysfunction syndrome. The purpose of this article is to describe the association of multiple organ dysfunction syndrome with a variety of conditions and therapies in an attempt to identify similarities, differences, and opportunities for therapeutic intervention.

1Division of Pediatric Surgery, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA.

2Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

3Department of Surgery, University of North Carolina, North Carolina Jaycee Burn Center, Chapel Hill, NC.

4Department of Pediatric Surgery, UT-Health, Children’s Memorial Hermann Hospital, Houston, TX.

5Departments of Pediatrics and Biochemistry, Washington University in Saint Louis, Saint Louis, MO.

6Pediatric Trauma and Critical Illness Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD.

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 U.S. Department of Health and Human Services, or the U.S. government.

Drs. Upperman, Bucuvalas, and Doctor received support for article research from the National Institutes of Health (NIH). Dr. Cairns received funding from GlaxoSmithKline. Dr. Doctor’s institution received funding from the NIH (National Institute of General Medical Sciences R01GM113838), Department of Defense, and Children’s Discovery Institution. His institution received funding from the NIH, Department of Defense, and Children’s Discovery Institution. Dr. Tamburro’s former institution received funding from U.S. Food and Drug Administration Office of Orphan Product Development Grant Program and from Ony (provided the calfactant free of charge for the above grant which assessed the efficacy of exogenous surfactant in pediatric hematopoietic stem cell transplant patients with acute lung injury). He received funding from Springer Publishing for serving as an editor on a Pediatric Critical Care Study Guide: Text and Review, and he disclosed government work. The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: robert.tamburro@nih.gov

©2017The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies