Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive...

Area of Science:

• Pediatric critical care medicine
• Clinical informatics
• Evidence-based guideline development

Background:

• Existing pediatric organ dysfunction criteria relied heavily on expert opinion.
• There was a need for contemporary, evidence-based criteria for pediatric organ dysfunction.
• The Pediatric Organ Dysfunction Information Update Mandate (PODIUM) was convened to address this gap.

Framework:

• Systematic literature reviews were conducted to identify evidence for single organ dysfunction criteria.
• Criteria were derived for neurologic, cardiovascular, respiratory, gastrointestinal, hepatic, renal, hematologic, coagulation, endocrine, endothelial, and immune systems.
• Consensus was achieved on 43 criteria for pediatric organ dysfunction.

Implementation:

• An international expert panel of 88 members from 47 institutions across 7 countries was assembled.
• Searches of PubMed and Embase (1992-2020) identified studies reporting original data in critically ill children.
• Studies evaluated performance of scoring tools/assessments and patient-centered outcomes, with risk of bias assessed.

Implications:

• The PODIUM criteria offer a contemporary foundation for research into pediatric organ dysfunction.
• These criteria will aid in identifying and studying single and multiple organ dysfunction in critically ill children.
• Validation of the PODIUM criteria is necessary for widespread clinical adoption.