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Refining the Pediatric Multiple Organ Dysfunction Syndrome.

Scott L Weiss1, Joseph A Carcillo2, Francis Leclerc3

  • 1Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Pennsylvania.

Pediatrics
|December 31, 2021
PubMed
Summary
This summary is machine-generated.

The term multiple organ dysfunction syndrome (MODS) in children should be reserved for cases with a common underlying cause affecting multiple organ systems. Differentiating MODS from additive organ dysfunctions is crucial for advancing pediatric critical care research and treatment.

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Area of Science:

  • Pediatric critical care medicine
  • Pathophysiology of critical illness
  • Systemic inflammatory response

Background:

  • The term multiple organ dysfunction syndrome (MODS) has been broadly applied to pediatric patients with concurrent organ dysfunction since the 1970s.
  • Significant variability exists in the epidemiology, mechanisms, time course, and outcomes of pediatric multiple organ dysfunction.

Observation:

  • Current application of the term MODS lacks specificity, encompassing diverse clinical scenarios.
  • Pediatric organ injuries can result from common systemic mechanisms or distinct, individual causes.

Findings:

  • We propose reserving the term pediatric MODS for patients with a systemic pathologic state originating from a common mechanism affecting multiple organ systems simultaneously.
  • Children with organ injuries attributable to distinct mechanisms should be classified as having additive organ system dysfunctions, not MODS.

Implications:

  • Differentiating MODS from additive organ dysfunctions, though challenging, is essential for refining clinical and research priorities.
  • This distinction can guide a shift from organ-specific to more holistic strategies in pediatric diagnosis, monitoring, and therapy.
  • Advancing our understanding of underlying mechanisms is key to improving outcomes for critically ill children.