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Monitoring Severity of Multiple Organ Dysfunction Syndrome: New and Progressive Multiple Organ Dysfunction Syndrome,
Katri V Typpo1, Jacques R Lacroix
11Department of Pediatrics and the Steele Children's Research Center, University of Arizona College of Medicine, Tucson, AZ. 2Department of Pediatrics and Sainte-Justine Hospital, Université de Montréal, Montréal, QC, Canada.
Insights
New diagnostic criteria for pediatric multiple organ dysfunction syndrome (MODS) are needed. Current scoring systems require validation to improve assessment and monitoring of critically ill children with MODS.
Area of Science:
- Pediatric critical care medicine
- Clinical informatics
- Biostatistics
Background:
- Multiple organ dysfunction syndrome (MODS) is a significant cause of morbidity and mortality in critically ill children.
- Existing diagnostic criteria and scoring systems for MODS have limitations in accurately assessing severity and progression.
- There is a need for standardized and validated methods to monitor pediatric MODS.
Purpose of the Study:
- To review and discuss current diagnostic criteria for new and progressive pediatric MODS.
- To evaluate existing scoring systems for assessing and monitoring MODS severity and progression in children.
- To identify knowledge gaps and research priorities in pediatric MODS assessment.
Main Methods:
- Literature review, synthesis of research data, and expert consensus from a workshop.
- Discussion and debate on issues related to MODS monitoring and scoring systems.
- Focus on identifying areas for future research and validation.
Main Results:
- Multiple sets of MODS diagnostic criteria exist, but their predictive value can be enhanced.
- Existing scores like the Pediatric Logistic Organ Dysfunction (PELOD-2) score are candidates for monitoring.
- Further validation of new criteria and comparison with existing methods are necessary.
Conclusions:
- Current MODS diagnostic criteria require improvement in their predictive capabilities.
- Validated scoring systems are crucial for accurate assessment and monitoring of pediatric MODS.
- Future research should focus on validating new criteria and comparing their epidemiological impact with existing methods.
Objective:
To describe the diagnostic criteria of new and progressive multiple organ dysfunction syndrome and scoring systems that might be used to assess and monitor the severity and progression of multiple organ dysfunction syndrome in children presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development MODS 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 monitoring of the severity of multiple organ dysfunction syndrome including new and progressive multiple organ dysfunction syndrome and scoring systems 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:
Many sets of diagnostic criteria of multiple organ dysfunction syndrome are presently available. All are useful, but their diagnostic and predictive value can be improved. Several types of diagnostic criteria are candidates to describe the severity and to monitor the progression of cases of multiple organ dysfunction syndrome, which include existing scores of organ dysfunction: Pediatric Logistic Organ Dysfunction, version 2, daily Pediatric Logistic Organ Dysfunction, version 2, organ failure-free days, etc. If a new set of diagnostic criteria of multiple organ dysfunction syndrome is created, its value must be validated. Furthermore, the epidemiology of multiple organ dysfunction syndrome based on these new diagnostic criteria must be compared with the epidemiology found with the preexisting sets of diagnostic criteria. The reliability as well as the added values of additional or new candidate markers of organ dysfunction and multiple organ dysfunction syndrome severity must be studied and compared.
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