scholarly journals Gene expression signatures identify paediatric patients with multiple organ dysfunction who require advanced life support in the intensive care unit

EBioMedicine ◽  
2020 ◽  
Vol 62 ◽  
pp. 103122 ◽  
Author(s):  
Rama Shankar ◽  
Mara L. Leimanis ◽  
Patrick A. Newbury ◽  
Ke Liu ◽  
Jing Xing ◽  
...  
Keyword(s):  
Gene Expression ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Life Support ◽  
Advanced Life Support ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Paediatric Patients ◽  
Gene Expression Signatures

scholarly journals The Effects of Adjuvant Immunoglobulin M-Enriched Immunoglobulin Therapy on Mortality Rate and Renal Function in Sepsis-Induced Multiple Organ Dysfunction Syndrome: Retrospective Analysis of Intensive Care Unit Patients

2012 ◽  
Vol 40 (3) ◽  
pp. 1166-1174 ◽  
Author(s):  
L Yavuz ◽  
G Aynali ◽  
A Aynali ◽  
A Alaca ◽  
S Kutuk ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Renal Function ◽  
Intensive Care ◽  
Mortality Rate ◽  
Organ Dysfunction ◽  
Multiple Organ ◽  
Apache Ii ◽  
Control Group ◽  
Multiple Organ Dysfunction ◽  
Overall Mortality

OBJECTIVE: To determine the effect of immunoglobulin (Ig)M-enriched Ig therapy on mortality rate and renal function in sepsis-induced multiple organ dysfunction syndrome (MODS), using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. METHODS: Retrospective study of patients with sepsis-induced MODS treated with standard antibiotic plus supportive therapy (control group) or IgM-enriched Ig therapy adjuvant to control group therapy (IVIg group). Total length of stay in the intensive care unit (ICU), overall mortality rate and 28-day case fatality rate (CFR), as well as APACHE II scores and renal function parameters at day 1 and day 4 of therapy, were recorded. RESULTS: A total of 118 patients were included (control group, n = 62; IVIg group, n = 56). In both groups, day 4 APACHE II scores decreased significantly compared with day 1 scores; the effect of treatment on renal function was minimal. Length of ICU stay, overall mortality rate and 28-day CFR were significantly lower in the IVIg group compared with the control group. CONCLUSIONS: Adding IgM-enriched Ig therapy to standard therapy for MODS improved general clinical conditions and significantly reduced APACHE II scores, overall mortality rate and 28-day CFR, although effects on renal function were minimal.

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

scholarly journals Acute kidney injury in pediatric patients: experience of a single center during an 11-year period

Medicina ◽  
2010 ◽  
Vol 46 (8) ◽  
pp. 511 ◽  
Author(s):  
Birutė Pundzienė ◽  
Diana Dobilienė ◽  
Šarūnas Rudaitis
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Second Period

The aim of our study was to determine the causes of acute kidney injury (AKI) in children, to compare outcomes between two periods – 1998–2003 and 2004-2008 – and to evaluate the influence of new methods of renal replacement therapy on mortality. Material and methods. A retrospective analysis of medical record data of all children treated for AKI at the Clinic of Children Diseases, Hospital of Kaunas University of Medicine, during the period of 1998–2008 was made. Both periods were compared regarding various variables. Results. Of the 179 children with AKI, 75 (41.9%) were treated during 1998–2003 and 104 (58.1%) during 2004–2008. Primary glomerular disease and sepsis were the leading causes of AKI in both the periods. AKI without involvement of other organs was diagnosed for 106 (59.2%) children: for 42 (56.0%) children in the first period and 64 (61.5%) in the second. A total of 124 (69.3%) children were treated in a pediatric intensive care unit. Multiple organ dysfunction syndrome with AKI was diagnosed for 33 (44%) patients in the first period and for 40 (38.5%) in the second. A significant decrease in mortality among patients with multiple organ dysfunction syndrome during the second period was observed (78.8% vs. 37.5%). Conclusions. More than half of patients had secondary acute kidney injury of nonrenal origin. More than two-thirds (69.3%) of patients with AKI were treated in the pediatric intensive care unit. Multiple organ dysfunction syndrome was diagnosed for 40.8% of children with AKI. Renal replacement therapy was indicated for one-third of patients with AKI. A 2.5-fold decrease in mortality was observed in the second period as compared to the first one.

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

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