Observational studyPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2019
Outcomes of Day 1 Multiple Organ Dysfunction Syndrome in the PICU.
Observational study 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, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Scoring Systems for Organ Dysfunction and Multiple Organ Dysfunction: The PODIUM Consensus Conference.Pediatrics · 2022Pooled it
- Effect of Saline vs Gluconate/Acetate-Buffered Solution vs Lactate-Buffered Solution on Serum Chloride Among Children in the Pediatric Intensive Care Unit: The SPLYT-P Randomized Clinical Trial.JAMA pediatrics · 2023Trial
- Developing organ dysfunction diagnostic criteria for children with cancer and post-hematopoietic cell transplantation: protocol of systematic review.Frontiers in oncology · 2025Article
- Factors Associated with Pediatric In-Hospital Recurrent Cardiac Arrest.Journal of pediatric intensive care · 2024Article
- An In-Depth Look at Nutrition Support and Adequacy for Critically Ill Children with Organ Dysfunction.Children (Basel, Switzerland) · 2024Article
- Patterns of Multiple Organ Dysfunction and Renal Recovery in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy.Critical care explorations · 2024Article
- Predicting Pediatric ICU Outcomes: Yet Another SOFA (Study) on the PODIUM?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Prognostic factors for multi-organ dysfunction in pediatric oncology patients admitted to the pediatric intensive care unit.Frontiers in oncology · 2023Article
- Early and late acute kidney injury: temporal profile in the critically ill pediatric patient.Clinical kidney journal · 2022Article
- Multiple Organ Dysfunction Interactions in Critically Ill Children.Frontiers in pediatrics · 2022Article
- Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.Pediatrics · 2022Article
- Refining the Pediatric Multiple Organ Dysfunction Syndrome.Pediatrics · 2022Article
- Observational
- Does Non-Neurologic Multiorgan Dysfunction After Out-of-Hospital Cardiac Arrest among Children Admitted in Coma Predict Outcome 1 Year Later?Journal of pediatric intensive care · 2021Article
- Hexosylceramides and Glycerophosphatidylcholine GPC(36:1) Increase in Multi-Organ Dysfunction Syndrome Patients with Pediatric Intensive Care Unit Admission over 8-Day Hospitalization.Journal of personalized medicine · 2021Article
- Observational
- The Feasibility of Studying Metabolites in PICU Multi-Organ Dysfunction Syndrome Patients over an 8-Day Course Using an Untargeted Approach.Children (Basel, Switzerland) · 2021Article
- Early Prediction of Multiple Organ Dysfunction in the Pediatric Intensive Care Unit.Frontiers in pediatrics · 2021Article
- Clinician Accuracy in Identifying and Predicting Organ Dysfunction in Critically Ill Children.Critical care medicine · 2020Article
- Hydrocortisone treatment is associated with a longer duration of MODS in pediatric patients with severe sepsis and immunoparalysis.Critical care (London, England) · 2020Article
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7 authors.
Funding
Abstract
objectivesWe sought to describe current outcomes of Multiple Organ Dysfunction Syndrome present on day 1 of PICU admission.
designRetrospective observational cohort study.
settingVirtual Pediatric Systems, LLC, database admissions, January 2014 and December 2015. PATIENTS: We analyzed 194,017 consecutive PICU admissions, (age 1 mo to 18 yr) from the 2014-2015 Virtual Pediatric Systems database.
interventionsWe identified day 1 Multiple Organ Dysfunction Syndrome by International Pediatric Sepsis Consensus Conference criteria with day 1 laboratory and vital sign values. Functional status was evaluated by Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scores from PICU admission and discharge. MEASUREMENTS AND MAIN
resultsOverall, PICU mortality was 2.1%. We identified day 1 Multiple Organ Dysfunction Syndrome in 14.4% of admissions. Patients with Multiple Organ Dysfunction Syndrome had higher mortality than those without Multiple Organ Dysfunction Syndrome (10.3% vs 0.7%; p < 0.0001), and a higher percentage of survivors had greater than or equal to 2 category worsening in Pediatric Cerebral Performance Category score (3.6% vs 0.5%; p < 0.0001) or Pediatric Overall Performance Category score (6.0% vs 1.8%; p < 0.0001). The odds of death with day 1 Multiple Organ Dysfunction Syndrome was 14.3 (95% CI, 13-15.7), while the odds of death or discharge with Pediatric Overall Performance Category/Pediatric Cerebral Performance Category score greater than or equal to 3 (poor functional outcome) was 6.7 (95% CI, 6-7.4). In a subset of 148,188 patients from hospitals where limitation of support decisions were recorded, 5.8% patients with Multiple Organ Dysfunction Syndrome had limitation of support decisions in place, compared with 0.8% of patients without Multiple Organ Dysfunction Syndrome (p < 0.0001). Of day 1 Multiple Organ Dysfunction Syndrome patients who died, 43.1% had limitation of support decisions in place, and 41.6% had withdrawal of life-sustaining therapies (p < 0.0001).
conclusionsMultiple Organ Dysfunction Syndrome present on day 1 of admission continues to be a major source of morbidity and mortality in the PICU, but risk of poor neurologic outcome may be improved. Further research is needed to understand decisions regarding limitation of support and withdrawal of life-sustaining therapy decisions in patients admitted with day 1 Multiple Organ Dysfunction Syndrome.
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