Related Experiment Video
Updated: Apr 11, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Organ Weight Measured at Autopsy in Critically Ill Children
François Proulx1, Julie Guilemette2, Nadia Roumeliotis1
11 Department of Pediatrics, Section of Intensive Care Medicine, Sainte-Justine Hospital, Univesity of Montreal, Montreal (Quebec), Canada.
Insights
Organ weights in critically ill children admitted to the pediatric intensive care unit (ICU) show significant increases in heart, lungs, kidneys, and liver. The brain, however, appears relatively smaller in cases of chronic disease.
Area of Science:
- Pediatric Pathology
- Critical Care Medicine
- Autopsy Studies
Background:
- Organ weight abnormalities can indicate disease severity in critically ill children.
- Understanding these changes is crucial for interpreting autopsy findings in pediatric intensive care unit (ICU) patients.
Purpose of the Study:
- To investigate the correlation between organ weights at autopsy and disease acuity in pediatric ICU admissions.
- To compare organ weight Z scores across different disease categories in critically ill children.
Main Methods:
- Autopsy organ weights (heart, lungs, kidneys, liver, spleen, brain) were collected from 68 pediatric ICU cases.
- Organ weight Z scores were calculated using established reference values for children.
- Patients were categorized based on disease acuity: acute illness, chronic disease with malformations, and chronic disease without malformations.
Main Results:
- Organ weight Z scores for heart, lungs, kidneys, liver, and spleen were significantly increased in pediatric ICU patients.
- Brain weight Z scores were lower compared to other organs, particularly in patients with chronic disease pathologies.
- Organ weight Z scores were similar across subgroups, except for the brain, which showed a statistically significant decrease in chronic disease groups.
Conclusions:
- Critically ill children in the ICU exhibit heterogeneous organ weight distributions at autopsy.
- Heart, lungs, kidneys, and liver are most frequently heavier than expected in this population.
- A relatively smaller brain weight is observed in pediatric ICU patients with chronic disease pathologies.
Abstract:
We determined whether organ weights at autopsy are correlated with disease acuity leading to pediatric intensive care unit (ICU) admission and death. The weights of heart, lungs, kidneys, liver, spleen, and brain were recorded in 68 pediatric ICU cases. For each organ, weight Z scores were calculated based on reference values previously established in large cohorts of deceased children by Kayser (any organ), or Dekaban and Sadowsky (brain only). Organ weight Z scores in pediatric ICU patients were severely increased (median [range] for heart, +3.2 [-6.3 to +37.7]; lungs, +3.0 [-8.6 to +38.1]; kidneys, +3.6 [-10.0 to +56.3]; liver, +4.2 [-14.9 to +70.5]; and spleen, +1.3 [-11.5 to +155.8]). Conversely, the brain weight Z score was lower compared to any other organ using either set of reference values: Kayser, -1.1 (-10.5 to +10.6; P < 0.0001); Dekaban and Sadowsky, -0.2 (-7.4 to +7.7; P < 0.0001). Pediatric ICU cases were subdivided based on disease acuity: (1) previously healthy with an acute illness (n = 11), (2) chronic disease due to congenital malformations (n = 29), and (3) chronic disease without any detectable malformation (n = 28). Organ weight Z scores were similar among subgroups with the exception of the brain, which was statistically decreased in chronic disease pathologies (groups 2 and 3). Overall, this study demonstrates the heterogenous distribution of organ weights at autopsy in critically ill children; the weight of heart, lungs, kidneys, and liver, being most frequently increased. The brain is relatively smaller in chronic disease pathologies of pediatric ICU patients.
