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Author Notes:

Address Correspondence to: Allan Doctor, MD, Professor of Pediatrics and Biochemistry, Director, Division of Pediatric Critical Care Medicine, Washington University School of Medicine, Campus Box 8208, 5th Floor McDonnell Pediatric Research Building, 660 South Euclid Avenue, Saint Louis, MO 63108, doctor@wustl.edu

We thank the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and their Office of Science Policy, Analysis and Communications for their support of this Workshop.

Disclaimer: 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.

Subjects:

Research Funding:

This manuscript is funded in part by: R01GM113838 (AD); R01AI097434 (JBW); and the Burroughs Welcome Foundation Investigators in the Pathogenesis of Infectious Disease (JBW)

Keywords:

  • Multiple organ dysfunction syndrome
  • Pediatrics
  • Nutrition
  • Bacterial translocation
  • Microbiome
  • Extracorporeal membrane oxygenation
  • Therapeutic plasma exchange
  • Continuous renal replacement therapy
  • Hemophagocytic lymphohistiocytosis
  • Macrophage activation syndrome
  • Anti-cytokine therapy
  • Bacterial toxin-mediated disease
  • Anti-toxin therapy
  • Corticosteroids
  • Hydrocortisone
  • Mineralocorticoids
  • Aldosterone
  • Gonadocorticoids
  • Oxandrolone
  • Tight glucose control
  • Anti-oxidant therapy

Pediatric Multiple Organ Dysfunction Syndrome: Promising Therapies

Tools:

Journal Title:

Pediatric Critical Care Medicine

Volume:

Volume 18, Number 3 Suppl 1

Publisher:

, Pages S67-S82

Type of Work:

Article | Post-print: After Peer Review

Abstract:

OBJECTIVE: To describe the state of the science, identify knowledge gaps, and offer potential future research questions regarding promising therapies for children with multiple organ dysfunction syndrome presented during the Eunice Kennedy Shriver National Institute of Child Health and Human Development Workshop on Pediatric Multiple Organ Dysfunction Syndrome (March 26-27, 2015). 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 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 relevant literature. CONCLUSIONS: Among critically ill children, multiple organ dysfunction syndrome is relatively common and associated with significant morbidity and mortality. For outcomes to improve, effective therapies aimed at preventing and treating this condition must be discovered and rigorously evaluated. In this article, a number of potential opportunities to enhance current care are highlighted including the need for a better understanding of the pharmacokinetics and pharmacodynamics of medications, the effect of early and optimized nutrition, and the impact of effective glucose control in the setting of multiple organ dysfunction syndrome. Additionally, a handful of the promising therapies either currently being implemented or developed are described. These include extracorporeal therapies, anticytokine therapies, antitoxin treatments, antioxidant approaches, and multiple forms of exogenous steroids. For the field to advance, promising therapies and other therapies must be assessed in rigorous manner and implemented accordingly.

Copyright information:

© 2017 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. Unauthorized reproduction of this article is prohibited.

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