ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2017
Three Hypothetical Inflammation Pathobiology Phenotypes and Pediatric Sepsis-Induced Multiple Organ Failure Outcome.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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Who cites it
44 citing papers in PubMed, 98 citations in OpenAlex.
- Adults with septic shock and extreme hyperferritinemia exhibit pathogenic immune variation.Genes and immunity · 2019Trial
- Presenting Characteristics Associated With Outcome in Children With Severe Traumatic Brain Injury: A Secondary Analysis From a Randomized, Controlled Trial of Therapeutic Hypothermia.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2018Trial
- Advancing Microcirculatory Therapies in Pediatric Sepsis: Current Opportunities and Future Directions.Journal of intensive care medicine · 2026Review
- Plasma Linoleic Acid Is Associated With Pediatric Sepsis Phenotype and Acute Kidney Injury.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026Article
- Article
- Potential biomarkers used for risk estimation of pediatric sepsis-associated organ dysfunction and immune dysregulation.Pediatric research · 2025Review
- Thrombocytopenia in Critically Ill Children: A Review for Practicing Clinicians.Children (Basel, Switzerland) · 2025Review
- Physiologically Based Pharmacokinetic Modelling in Critically Ill Children Receiving Anakinra While on Extracorporeal Life Support.Clinical pharmacokinetics · 2024Article
- From Pediatric Sepsis Epidemiologic Data to Improved Clinical Outcomes.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024Article
- Cytokine Storm and Sepsis-Induced Multiple Organ Dysfunction Syndrome.Advances in experimental medicine and biology · 2024Review
- Clinical Sepsis Phenotypes in Critically Ill Patients.Microorganisms · 2023Review
- Pediatric Swine Model of Methicillin-ResistantCritical care explorations · 2023Article
- Ferritin in pediatric critical illness: a scoping review.Clinical and experimental pediatrics · 2023Article
- Commentary: 'Critical illness subclasses: all roads lead to Rome'.Critical care (London, England) · 2022Article
- Thrombocytopenia and Bloodstream Infection: Incidence and Implication on Length of Stay in the Pediatric Intensive Care Unit.Journal of pediatric intensive care · 2022Article
- Fatal Pediatric Melioidosis and the Role of Hyperferritinemic Sepsis-Induced Multiple-Organ Dysfunction Syndrome.The American journal of tropical medicine and hygiene · 2022Article
- Subtypes and Mimics of Sepsis.Critical care clinics · 2022Review
- Sepsis with liver dysfunction and coagulopathy predicts an inflammatory pattern of macrophage activation.Intensive care medicine experimental · 2022Article
- Platelets in pediatric and neonatal sepsis: novel mediators of the inflammatory cascade.Pediatric research · 2022Review
- Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.Pediatrics · 2022Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesWe hypothesize that three inflammation pathobiology phenotypes are associated with increased inflammation, proclivity to develop features of macrophage activation syndrome, and multiple organ failure-related death in pediatric severe sepsis.
designProspective cohort study comparing children with severe sepsis and any of three phenotypes: 1) immunoparalysis-associated multiple organ failure (whole blood ex vivo tumor necrosis factor response to endotoxin < 200 pg/mL), 2) thrombocytopenia-associated multiple organ failure (new onset thrombocytopenia with acute kidney injury and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 activity < 57%), and/or 3) sequential multiple organ failure with hepatobiliary dysfunction (respiratory distress followed by liver dysfunction with soluble Fas ligand > 200 pg/mL), to those without any of these phenotypes.
settingTertiary children's hospital PICU. PATIENTS: One hundred consecutive severe sepsis admissions.
interventionsClinical data were recorded daily, and blood was collected twice weekly. MEASUREMENTS AND MAIN
resultsMultiple organ failure developed in 75 cases and eight died. Multiple organ failure cases with any of the three inflammation phenotypes (n = 37) had higher inflammation (C-reactive protein, p = 0.009 and ferritin, p < 0.001) than multiple organ failure cases without any of these phenotypes (n = 38) or cases with only single organ failure (n = 25). Development of features of macrophage activation syndrome and death were more common among multiple organ failure cases with any of the phenotypes (macrophage activation syndrome: 10/37, 27%; death: 8/37, 22%) compared to multiple organ failure cases without any phenotype (macrophage activation syndrome: 1/38, 3%; p = 0.003 and death: 0/38, 0%; p = 0.002).
conclusionsOur approach to phenotype categorization remains hypothetical, and the phenotypes identified need to be confirmed in multicenter studies of pediatric multiple organ dysfunction syndrome.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.