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New or Progressive Multiple Organ Dysfunction Syndrome in Pediatric Severe Sepsis: A Sepsis Phenotype With Higher Morbidity and Mortality

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作者：
Lin, J.C[] * ; Spinella, P.C[] ; Fitzgerald, J.C[] ; Tucci, M[] ; Bush, J.L[] ; Nadkarni, V.M[] ; Thomas, N.J[] ; Weiss, S.L[] ; Fontela, P[] ; Tucci, M[] ; Dumistrascu, M[] ; Skippen, P[] ; Krahn, G[] ; Bezares, E[] ; Puig, G[] ; Puig-Ramos, A[] ; Garcia, R[] ; Villar, M[] ; Bigham, M[] ; Polanski, T[] ; Latifi, S[] ; Giebner, D[] ; Anthony, H[] ; Hume, J[] ; Galster, A[] ; Linnerud, L[] ; Sanders, R[] ; Hefley, G[] ; Madden, K[] ; Thompson, A[] ; Shein, S[] ; Gertz, S[] ; Han, Y[] ; Williams, T[] ; Hughes-Schalk, A[] ; Chandler, H[] ; Orioles, A[] ; Zielinski, E[] ; Doucette, A[] ; Orioles, A[] ; Zielinski, E[] ; Doucette, A[] ; Zebuhr, C[] ; Wilson, T[] ; Dimitriades, C[] ; Ascani, J[] ; Layburn, S[] ; Valley, S[] ; Markowitz, B[] ; Terry, J[] ; Morzov, R[] ; Mcinnes, A[] ; McArthur, J[] ; Woods, K[] ; Murkowski, K[] ; Spaeder, M[] ; Sharron, M[] ; Wheeler, D[] ; Beckman, E[] ; Frank, E[] ; Howard, K[] ; Carroll, C[] ; Nett, S[] ; Jarvis, D[] ; Patel, V[] ; Higgerson, R[] ; Christie, L[] ; Typpo, K[] ; Deschenes, J[] ; Kirby, A[] ; Uhl, T[] ; Rehder, K[] ; Cheifetz, I[] ; Wrenn, S[] ; Kypuros, K[] ; Ackerman, K[] ; Maffei, F[] ; Bloomquist, G[] ; Rizkalla, N[] ; Kimura, D[] ; Shah, S[] ; Tigges, C[] ; Su, F[] ; Barlow, C[] ; Michelson, K[] ; Wolfe, K[] ; Goodman, D[] ; Campbell, L[] ; Sorce, L[] ; Bysani, K[] ; Monjure, T[] ; Evans, M[] ; Totapally, B[] ; Chegondi, M[] ; Rodriguez, C[] ; Frazier, J[] ; Steele, L[] ; Viteri, S[] ; Costarino, A[] ; Spear, D[] ; Hirshberg, E[] ; Lilley, J[] ; Rowan, C[] ; Rider, C[] ; Kane, J[] ; Zimmerman, J[] ; Greeley, C[] ; Lin, J[] ; Jacobs, R[] ; Parker, M[] ; Culver, K[] ; Loftis, L[] ; Jaimon, N[] ; Goldsworthy, M[] ; Diliberto, M[] ; Alen, C[] ; Gessouroun, M[] ; Sapru, A[] ; Lang, T[] ; Alkhouli, M[] ; Kamath, S[] ; Friel, D[] ; Daufeldt, J[] ; Hsing, D[] ; Carlo, C[] ; Pon, S[] ; Scimeme, J[] ; Shaheen, A[] ; Hassinger, A[] ; Qiao, H[] ; Giuliano, J[] ; Tala, J[] ; Vinciguerra, D[] ; Fernandez, A[] ; Carrero, R[] ; Hoyos, P[] ; Jaramillo, J[] ; Posada, A[] ; Izquiierdo, L[] ; Pineres Olave, B.E[] ; Donado, J[] ; Dalmazzo, R[] ; Rendich, S[] ; Palma, L[] ; Lapadula, M[] ; Acuna, C[] ; Cruces, P[] ; De Clety, S.C[] ; Dujardin, M[] ; Berghe, C[] ; Renard, S[] ; Zurek, J[] ; Steinherr, H[] ; Mougkou, K[] ; Critselis, E[] ; Mougkou, K[] ; Di Nardo, M[] ; Picardo, S[] ; Tortora, F[] ; Rossetti, E[] ; Fragasso, T[] ; Cogo, P[] ; Netto, R[] ; Dagys, A[] ; Gurskis, V[] ; Kevalas, R[] ; Neeleman, C[] ; Lemson, J[] ; Luijten, C[] ; Wojciech, K[] ; Pagowska-Klimek, I[] ; Szczepanska, M[] ; Karpe, J[] ; Nunes, P[] ; Almeida, H[] ; Rios, J[] ; Vieira, M[] ; Garcia Iniguez, J.P[] ; Revilla, P[] ; Urbano, J[] ; Lopez-Herce, J[] ; Bustinza, A[] ; Cuesta, A[] ; Hofheinz, S[] ; Rodriguez-Nunez, A[] ; Sanagustin, S[] ; Gonzalez, E[] ; Riaza, M[] ; Piaya, R[] ; Soler, P[] ; Esteban, E[] ; Laraudogoitia, J[] ; Monge, C[] ; Herrera, V[] ; Granados, J[] ; Gonzalez, C[] ; Koroglu, T[] ; Ozcelik, E[] ; Baines, P[] ; Plunkett, A[] ; Davis, P[] ; George, S[] ; Tibby, S[] ; Harris, J[] ; Agbeko, R[] ; Lampitt, R[] ; Brierley, J[] ; Peters, M[] ; Jones, A[] ; Dominguez, T[] ; Thiruchelvam, T[] ; Deep, A[] ; Ridley, L[] ; Bowen, W[] ; Levin, R[] ; Macleod, I[] ; Gray, M[] ; Hemat, N[] ; Alexander, J[] ; Ali, S[] ; Pappachan, J[] ; McCorkell, J[] ; Fortune, P[] ; MacDonald, M[] ; Hudnott, P[] ; Suyun, Q[] ; Singhi, S[] ; Nallasamy, K[] ; Lodha, R[] ; Shime, N[] ; Tabata, Y[] ; Saito, O[] ; Ikeyama, T[] ; Kawasaki, T[] ; Lum, L[] ; Abidin, A[] ; Kee, S[] ; Tang, S[] ; Jalil, R[] ; Guan, Y[] ; Yao, L[] ; Lin, K[] ; Ong, J[] ; Salloo, A[] ; Doedens, L[] ; Mathivha, L[] ; Reubenson, G[] ; Moaisi, S[] ; Pentz, A[] ; Green, R[] ; Schibler, A[] ; Fernandez, A[] ; Erickson, S[] ; McEneiry, J[] ; Long, D[] ; Dorofaeff, T[] ; Coulthard, M[] ; Millar, J[] ; Delzoppo, C[] ; Williams, G[] ; Morritt, M[] ; Watts, N[] ; Morritt, M[] ; Beca, J[] ; Sherring, C[] ; Bushell, T[] ;
机构： [a]Division of Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States [b]Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States [c]Division of Critical Care Medicine, Department of Pediatrics, University of Montreal, Montreal, QC, Canada [d]Pediatric Critical Care Medicine, Departments of Pediatrics and Public Health Sciences, Penn State University College of Medicine, Hershey, PA, United States [e]Montreal Children's Hospital-McGill, Canada [f]Sainte Justine Hospital, United States [g]BC Children's Hospital, United States [h]Hospital Cardiovascular de Puerto Rico y el Caribe, Puerto Rico [i]San Jorge Children's Hospital, United States [j]University Pediatric Hospital, United States [k]Akron Children's Hospital, United States [l]Amplatz Children's Hospital, United States [m]Arkansas Children's Hospital, United States [n]Boston Children's Hospital, United States [o]Children's Hospital of Pittsburgh, United States [p]Children's Hospital-Hackensack, United States [q]Children's Mercy Hospital, United States [r]Children's Healthcare of Atlanta, United States [s]Children's Hospital in Minnesota, United States [t]Children's Hospital St. Paul, United States [u]Children's Hospital Colorado, United States [v]Children's Hospital New Orleans, United States [w]Children's Hospital of Los Angeles, United States [x]Children's Hospital of Monmouth, United States [y]Children's Hospital of Wisconsin, United States [z]Children's National Medical Center, United States [aa]Cincinnati Children's Medical Center, United States [ab]Connecticut Children's, United States [ac]Dartmouth Hitchcock, United States [ad]Dayton Children's Hospital, United States [ae]Dell Children's Medical Center, United States [af]Diamond Children's Hospital, United States [ag]Doernbecher Children's Hospital, United States [ah]Duke Children's Hospital, United States [ai]El Paso Children's Hospital, United States [aj]Golisano Children's Hospital, United States [ak]Janet Weis/Geisinger, United States [al]Johns Hopkins, United States [am]Le Bonheur Children's Hospital, United States [an]Lucile Packard Children's Hospital, United States [ao]Lurie Children's Hospital of Chicago, United States [ap]Medical City Children's-Dallas, United States [aq]Medical University of South Carolina, United States [ar]Miami Children's Hospital, United States [as]Nationwide Children's Hospital, United States [at]Nemours/Alfred I. duPont Children's Hospital, United States [au]Penn State Hershey Medical Center, United States [av]Primary Children's Medical Center, United States [aw]Riley Hospital for Children, United States [ax]Rush Children's Hospital, United States [ay]Seattle Children's Hospital, United States [az]St. Louis Children's Hospital, United States [ba]Stony Brook University, United States [bb]Texas Children's Hospital, United States [bc]Oklahoma University Medical Center, United States [bd]University of California San Francisco, United States [be]University of Iowa, United States [bf]Weill Cornell Medical Center, United States [bg]Wolfson Children's Hospital, United States [bh]Women and Children's Hospital of Buffalo, United States [bi]Yale Children's Hospital, United States [bj]Hospital Durand, Argentina [bk]Clinica Infantil Colsubsidio, Colombia [bl]Hospital de San Jose, United States [bm]Hospital General de Medellin, United States [bn]Hospital Military Central, United States [bo]Pablo Tobon Uribe, Colombia [bp]Clinica Las Condes, Chile [bq]Clinica Santa Maria, Chile [br]Hospital Luis Calvo Mackenna, Chile [bs]Hospital Padre Hurtado, Chile [bt]St. Luc University Hospital, Belgium [bu]Masaryk University, Czech Republic [bv]Klinikum Augsburg, Germany [bw]Aghia Sophia Children's Hospital, Greece [bx]P. and A. Kyriakou Children's Hospital, Algeria [by]Bambino Gesu Area Rossa, Italy [bz]Bambino Gesu Children's Hospital, Italy [ca]Bambino Gesu Pediatrico, Italy [cb]Lithuanian University of Health Sciences, Lithuania [cc]Radboud University Medical Centre, Netherlands [cd]Polish Mother Memorial Hospital, Poland [ce]Szyszko (Ślaskiego University), Poland [cf]Hospital Prof Dr. Fernando Fonseca, Portugal [cg]Centrol Hospitalar Lisboa Norte, Portugal [ch]Children's Hospital Miguel Servet, Spain [ci]Hospital General Universitario Gregorio Marañón, Spain [cj]Hospital 12 de Octubre, Spain [ck]Hospital Clínico Universitario, Venezuela [cl]Hospital de la Sant Creu Sant Pau, Spain [cm]Hospital Universitario Madrid, Spain [cn]Hospital Carlos Haya Materno Infantil, Spain [co]Hospital Sant Joan de Déu, Spain [cp]Hospital Universitario Donostia, Spain [cq]Hospital Universitario Salamanca, Spain [cr]Hospital Virgen de la Arrixaca, Spain [cs]Dokuz Eylul University, Turkey [ct]Alder Hey Children's Hospital, United Kingdom [cu]Birmingham Children's Hospital, United Kingdom [cv]Bristol Royal Hospital for Children, United Kingdom [cw]Evelina Children's Hospital, United Kingdom [cx]Great North Children's Hospital-Newcastle, United Kingdom [cy]Great Ormond Street, United Kingdom [cz]King's College Hospital, United Kingdom [da]Royal Hospital for Sick Children, United Kingdom [db]St George's Hospital, United Kingdom [dc]University Hospital of North Staffordshire NHS Trust, United Kingdom [dd]University Hospital Southampton NHS Foundation Trust, United Kingdom [de]Royal Manchester Children's Hospital, United Kingdom [df]Beijing Children's Hospital, China [dg]Advanced Pediatrics, India [dh]All India Institute, India [di]Kyoto Prefectural, Japan [dj]Tokyo Metropolitan, Japan [dk]Shizuoka Children's Hospital, Japan [dl]University Malaya Medical Center, Malaysia [dm]Kebangsaan Malaysia Medical Center, Malaysia [dn]KK Women's and Children's Hospital, Singapore [do]National University Hospital, Singapore [dp]Chris Hani Baragwanath, South Africa [dq]Rahima Moosa, South Africa [dr]Steve Biko Academic Hospital, South Africa [ds]Mater Children's Hospital, Australia [dt]Princess Margaret Hospital, Canada [du]Royal Children's Hospital Brisbane, Australia [dv]Royal Children's Melbourne, Australia [dw]Sydney Children's Hospital, Australia [dx]Children's Hospital Westmead, Australia [dy]Starship Children's Hospital, New Zealand
出处：
DOI： 10.1097/PCC.0000000000000978
ISSN：

关键词： children epidemiology multiple organ dysfunction syndrome severe sepsis

摘要：
Objectives: To describe the epidemiology, morbidity, and mortality of new or progressive multiple organ dysfunction syndrome in children with severe sepsis. Design: Secondary analysis of a prospective, cross-sectional, point prevalence study. Setting: International, multicenter PICUs. Patients: Pediatric patients with severe sepsis identified on five separate days over a 1-year period. Interventions: None. Measurements and Main Results: Of 567 patients from 128 PICUs in 26 countries enrolled, 384 (68%) developed multiple organ dysfunction syndrome within 7 days of severe sepsis recognition. Three hundred twenty-seven had multiple organ dysfunction syndrome on the day of sepsis recognition. Ninety-one of these patients developed progressive multiple organ dysfunction syndrome, whereas an additional 57 patients subsequently developed new multiple organ dysfunction syndrome, yielding a total proportion with severe sepsis-associated new or progressive multiple organ dysfunction syndrome of 26%. Hospital mortality in patients with progressive multiple organ dysfunction syndrome was 51% compared with patients with new multiple organ dysfunction syndrome (28%) and those with single-organ dysfunction without multiple organ dysfunction syndrome (10%) (p < 0.001). Survivors of new or progressive multiple organ dysfunction syndrome also had a higher frequency of moderate to severe disability defined as a Pediatric Overall Performance Category score of greater than or equal to 3 and an increase of greater than or equal to 1 from baseline: 22% versus 29% versus 11% for progressive, new, and no multiple organ dysfunction syndrome, respectively (p < 0.001). Conclusions: Development of new or progressive multiple organ dysfunction syndrome is common (26%) in severe sepsis and is associated with a higher risk of morbidity and mortality than severe sepsis without new or progressive multiple organ dysfunction syndrome. Our data support the use of new or progressive multiple organ dysfunction syndrome as an important outcome in trials of pediatric severe sepsis although efforts are needed to validate whether reducing new or progressive multiple organ dysfunction syndrome leads to improvements in more definitive morbidity and mortality endpoints. Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

基金：
Supported, in part, by the Endowed Chair, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine and the Center for Pediatric Clinical Effectiveness at The Children's Hospital of Philadelphia. Financial support for data collection in all U.K. centers was provided by the U.K. National Institute of Health (NIHR) Clinical Research Network and in Southampton by the Southampton NIHR Wellcome Trust Clinical Research Facility. Dr. Fitzgerald's institution received funding from the Children's Hospital of Philadelphia Center for Pediatric Clinical Effectiveness. Dr. Thomas received funding from Therabron and CareFusion; his institution received funding from the U.S. Food and Drug Administration. Dr. Weiss' institution received funding from the Center for Pediatric Clinical Effectiveness at The Children's Hospital of Philadelphia, NIGMS K23GM110496, and Thermo-Fisher Scientific (honorarium for lecture). The remaining authors have disclosed that they do not have any potential conflicts of interest.
语种：
外文
中科院(CAS)分区：
出版当年[2016]版：
大类 | 3 区 医学
小类 | 2 区 儿科 4 区 危重病医学
最新[2025]版：
大类 | 2 区 医学
小类 | 2 区 儿科 3 区 危重病医学
第一作者：
推荐引用方式(GB/T 7714)：
Lin J.C,Spinella P.C,Fitzgerald J.C,et al.New or Progressive Multiple Organ Dysfunction Syndrome in Pediatric Severe Sepsis: A Sepsis Phenotype With Higher Morbidity and Mortality[J].PEDIATRIC CRITICAL CARE MEDICINE.2017,18(1):doi:10.1097/PCC.0000000000000978.
APA：
Lin, J.C,Spinella, P.C,Fitzgerald, J.C,Tucci, M,Bush, J.L...&Bushell, T.(2017).New or Progressive Multiple Organ Dysfunction Syndrome in Pediatric Severe Sepsis: A Sepsis Phenotype With Higher Morbidity and Mortality.PEDIATRIC CRITICAL CARE MEDICINE,18,(1)
MLA：
Lin, J.C,et al."New or Progressive Multiple Organ Dysfunction Syndrome in Pediatric Severe Sepsis: A Sepsis Phenotype With Higher Morbidity and Mortality".PEDIATRIC CRITICAL CARE MEDICINE 18..1(2017)

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