Epidemiology and Outcomes of Pediatric Multiple Organ Dysfunction Syndrome

Overview

Journal Pediatr Crit Care Med

Specialty Pediatrics

Date 2017 Mar 2

PMID 28248829

Citations 49

Authors

R Scott Watson

Sheri S Crow

Mary E Hartman

Jacques Lacroix

Folafoluwa O Odetola

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Health Care Resource Use and Costs After Hospitalization With Multiple Organ Dysfunction in Children.

Odetola F, Lin P, Ye W, Dombkowski K, Linden A JAMA Netw Open. 2025; 8(1):e2456246.

PMID: 39878981 PMC: 11780478. DOI: 10.1001/jamanetworkopen.2024.56246.

Interaction of milrinone with extracorporeal life support.

Whelan A, Mim S, Hunt J, McKnite A, Green D, Imburgia C J Extra Corpor Technol. 2024; 56(4):167-173.

PMID: 39705580 PMC: 11661780. DOI: 10.1051/ject/2024014.

Therapeutic Plasma Exchange in Pediatric Patients: Results from a Single Center.

Dalkiran T, Mercan M, Ipek S, Gullu U, Kandur Y, Acipayam C J Pediatr Intensive Care. 2024; 13(3):282-285.

PMID: 39629152 PMC: 11379518. DOI: 10.1055/s-0041-1742252.

Multiple Organ Dysfunction Syndrome in Malawian Children with Cerebral Malaria.

Wynkoop H, Bevan A, Galeano X, Raees M, Haque M, Taylor T Am J Trop Med Hyg. 2024; 111(6):1223-1229.

PMID: 39378888 PMC: 11619499. DOI: 10.4269/ajtmh.24-0303.

An In-Depth Look at Nutrition Support and Adequacy for Critically Ill Children with Organ Dysfunction.

Knebusch N, Hong-Zhu P, Mansour M, Daughtry J, Fogarty T, Stein F Children (Basel). 2024; 11(6).

PMID: 38929288 PMC: 11202264. DOI: 10.3390/children11060709.

References

Als L, Nadel S, Cooper M, Pierce C, Sahakian B, Garralda M . Neuropsychologic function three to six months following admission to the PICU with meningoencephalitis, sepsis, and other disorders: a prospective study of school-aged children. Crit Care Med. 2013; 41(4):1094-103. DOI: 10.1097/CCM.0b013e318275d032. View

Farris R, Weiss N, Zimmerman J . Functional outcomes in pediatric severe sepsis: further analysis of the researching severe sepsis and organ dysfunction in children: a global perspective trial. Pediatr Crit Care Med. 2013; 14(9):835-42. PMC: 4080839. DOI: 10.1097/PCC.0b013e3182a551c8. View

Proulx F, Fayon M, Farrell C, Lacroix J, Gauthier M . Epidemiology of sepsis and multiple organ dysfunction syndrome in children. Chest. 1996; 109(4):1033-7. DOI: 10.1378/chest.109.4.1033. View

Demaret P, Tucci M, Karam O, Trottier H, Ducruet T, Lacroix J . Clinical Outcomes Associated With RBC Transfusions in Critically Ill Children: A 1-Year Prospective Study. Pediatr Crit Care Med. 2015; 16(6):505-14. DOI: 10.1097/PCC.0000000000000423. View

Baue A . Multiple, progressive, or sequential systems failure. A syndrome of the 1970s. Arch Surg. 1975; 110(7):779-81. DOI: 10.1001/archsurg.1975.01360130011001. View

Ceneviva G, Paschall J, Maffei F, Carcillo J . Hemodynamic support in fluid-refractory pediatric septic shock. Pediatrics. 1998; 102(2):e19. DOI: 10.1542/peds.102.2.e19. View

Fiser D . Outcome evaluations as measures of quality in pediatric intensive care. Pediatr Clin North Am. 1994; 41(6):1423-38. DOI: 10.1016/s0031-3955(16)38880-0. View

Typpo K, Petersen N, Petersen L, Mariscalco M . Children with chronic illness return to their baseline functional status after organ dysfunction on the first day of admission in the pediatric intensive care unit. J Pediatr. 2010; 157(1):108-113.e1. PMC: 4406357. DOI: 10.1016/j.jpeds.2009.12.029. View

Vermunt L, Buysse C, Aarsen F, Catsman-Berrevoets C, Duivenvoorden H, Joosten K . Long-term cognitive functioning in children and adolescents who survived septic shock caused by Neisseria meningitidis. Br J Clin Psychol. 2008; 48(Pt 2):195-208. DOI: 10.1348/014466508X391094. View

10.

Aspesberro F, Mangione-Smith R, Zimmerman J . Health-related quality of life following pediatric critical illness. Intensive Care Med. 2015; 41(7):1235-46. DOI: 10.1007/s00134-015-3780-7. View

11.

Seghaye M, Engelhardt W, Grabitz R, Faymonville M, Hornchen H, Messmer B . Multiple system organ failure after open heart surgery in infants and children. Thorac Cardiovasc Surg. 1993; 41(1):49-53. DOI: 10.1055/s-2007-1013820. View

12.

Corser N . Sleep of 1- and 2-year-old children in intensive care. Issues Compr Pediatr Nurs. 1996; 19(1):17-31. DOI: 10.3109/01460869609026852. View

13.

Bestati N, Leteurtre S, Duhamel A, Proulx F, Grandbastien B, Lacroix J . Differences in organ dysfunctions between neonates and older children: a prospective, observational, multicenter study. Crit Care. 2010; 14(6):R202. PMC: 3219976. DOI: 10.1186/cc9323. View

14.

Fontaine D . Sleep in the pediatric ICU: an empirical investigation. Am J Crit Care. 1997; 6(1):56-63. View

15.

Knoester H, Grootenhuis M, Bos A . Outcome of paediatric intensive care survivors. Eur J Pediatr. 2007; 166(11):1119-28. PMC: 2039787. DOI: 10.1007/s00431-007-0573-1. View

16.

Hanekamp M, Mazer P, van der Cammen-van Zijp M, van Kessel-Feddema B, Nijhuis-van Der Sanden M, Knuijt S . Follow-up of newborns treated with extracorporeal membrane oxygenation: a nationwide evaluation at 5 years of age. Crit Care. 2006; 10(5):R127. PMC: 1751085. DOI: 10.1186/cc5039. View

17.

Gemke R, Bonsel G, Van Vught A . Long-term survival and state of health after paediatric intensive care. Arch Dis Child. 1995; 73(3):196-201. PMC: 1511302. DOI: 10.1136/adc.73.3.196. View

18.

Davydow D, Richardson L, Zatzick D, Katon W . Psychiatric morbidity in pediatric critical illness survivors: a comprehensive review of the literature. Arch Pediatr Adolesc Med. 2010; 164(4):377-85. PMC: 2881634. DOI: 10.1001/archpediatrics.2010.10. View

19.

Lamas A, Otheo E, Ros P, Vazquez J, Maldonado M, Munoz A . Prognosis of child recipients of hematopoietic stem cell transplantation requiring intensive care. Intensive Care Med. 2003; 29(1):91-6. DOI: 10.1007/s00134-002-1549-2. View

20.

Leteurtre S, Duhamel A, Grandbastien B, Proulx F, Cotting J, Gottesman R . Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children. CMAJ. 2010; 182(11):1181-7. PMC: 2917930. DOI: 10.1503/cmaj.081715. View