Biomarkers associated with mortality in pediatric patients with cardiac arrest and acute respiratory distress syndrome

Gardner, Monique M.; Kirschen, Matthew; Wong, Hector R.; McKeone, Daniel; Halstead, E. Scott; Thompson, Jill; Himebauch, Adam S.; Topjian, Alexis; Yehya, Nadir

doi:10.1016/j.resuscitation.2021.11.036

Cited by 4 publications

(3 citation statements)

References 53 publications

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“…Early studies in patients examined the association of levels of single biomarkers with outcomes; however, the complexity of the pathobiology and biomarker changes suggested that this approach may be too simplistic. Since the publication of the first PALICC consensus recommendations, a number of studies have evaluated multiple plasma biomarkers (including many of those described above) and examined their relationship to other biomarkers and/or their relationship to the development or outcomes of PARDS (102–104, 107, 108, 114, 118, 122, 127, 128, 130, 131, 154–157). Approaches have included evaluating multiple biomarkers in regression models (108, 109), classification and regression tree analysis with mortality as the outcome (77, 131), and generating biomarker profiles (118, 158).…”

Section: Resultsmentioning

confidence: 99%

Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Grunwell

Dahmer

Sapru

et al. 2023

Pediatric Critical Care Medicine

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To review the literature for studies published in children on the pathobiology, severity, and risk stratification of pediatric acute respiratory distress syndrome (PARDS) with the intent of guiding current medical practice and identifying important areas for future research related to severity and risk stratification.DATA SOURCES: Electronic searches of PubMed and Embase were conducted from 2013 to March 2022 by using a combination of medical subject heading terms and text words to capture the pathobiology, severity, and comorbidities of PARDS. STUDY SELECTION:We included studies of critically ill patients with PARDS that related to the severity and risk stratification of PARDS using characteristics other than the oxygenation defect. Studies using animal models, adult only, and studies with 10 or fewer children were excluded from our review.DATA EXTRACTION: Title/abstract review, full-text review, and data extraction using a standardized data collection form. DATA SYNTHESIS:The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize relevant evidence and develop recommendations for clinical practice. There were 192 studies identified for full-text extraction to address the relevant Patient/ Intervention/Comparator/Outcome questions. One clinical recommendation was generated related to the use of dead space fraction for risk stratification. In addition, six research statements were generated about the impact of age on acute respiratory distress syndrome pathobiology and outcomes, addressing PARDS heterogeneity using biomarkers to identify subphenotypes and endotypes, and use of standardized ventilator, physiologic, and nonpulmonary organ failure measurements for future research. CONCLUSIONS:Based on an extensive literature review, we propose clinical management and research recommendations related to characterization and risk stratification of PARDS severity.

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Section: Resultsmentioning

confidence: 99%

Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Grunwell

Dahmer

Sapru

et al. 2023

Pediatric Critical Care Medicine

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“…Mortality has been associated with a sepsis-like host-response profile characterized by systemic inflammation and altered metabolism linked to bioenergetic deficits 2,[19][20][21][22] . In sepsis, mortality has been linked to immunoparalysis, organ damage including the cardiac, respiratory, hepatic and renal systems, uncontrolled inflammation, proteolysis, and defects of organ healing capability [23][24][25][26][27][28][29][30][31][32][33][34] . Mitochondrial and peroxisomal dysfunction involves kynurenine derivatives including intermediates of redox cofactors nicotinamide adenine dinucleotide (NAD), acylglycerophosphocholines, acyl-carnitines, and bile acids.…”

Section: Systemic Inflammation and Altered Metabolismmentioning

confidence: 99%

The Childhood Acute Illness and Nutrition (CHAIN) network nested case-cohort study protocol: a multi-omics approach to understanding mortality among children in sub-Saharan Africa and South Asia

et al. 2022

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Introduction: Many acutely ill children in low- and middle-income settings have a high risk of mortality both during and after hospitalisation despite guideline-based care. Understanding the biological mechanisms underpinning mortality may suggest optimal pathways to target for interventions to further reduce mortality. The Childhood Acute Illness and Nutrition (CHAIN) Network (www.chainnnetwork.org) Nested Case-Cohort Study (CNCC) aims to investigate biological mechanisms leading to inpatient and post-discharge mortality through an integrated multi-omic approach. Methods and analysis; The CNCC comprises a subset of participants from the CHAIN cohort (1278/3101 hospitalised participants, including 350 children who died and 658 survivors, and 270/1140 well community children of similar age and household location) from nine sites in six countries across sub-Saharan Africa and South Asia. Systemic proteome, metabolome, lipidome, lipopolysaccharides, haemoglobin variants, toxins, pathogens, intestinal microbiome and biomarkers of enteropathy will be determined. Computational systems biology analysis will include machine learning and multivariate predictive modelling with stacked generalization approaches accounting for the different characteristics of each biological modality. This systems approach is anticipated to yield mechanistic insights, show interactions and behaviours of the components of biological entities, and help develop interventions to reduce mortality among acutely ill children. Ethics and dissemination. The CHAIN Network cohort and CNCC was approved by institutional review boards of all partner sites. Results will be published in open access, peer reviewed scientific journals and presented to academic and policy stakeholders. Data will be made publicly available, including uploading to recognised omics databases. Trial registration NCT03208725.

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“…Recognizing the need for rapid, point-of-care diagnostics for sepsis subgroup stratification, he developed the PERSEVERE-II biomarker panel (5, 6), which is in the process of commercialization. His work has served to develop risk stratification strategies in sepsis-associated acute kidney injury (7), myocardial dysfunction (8), and acute respiratory distress syndrome (9, 10). He was adept at moving from bedside to bench, leveraging his findings in sepsis genomic data to elucidate the role of matrix metalloproteinase-8 (11, 12), olfactomedin-4 (13), and interleukin-27 (14), among others in sepsis pathophysiology.…”

mentioning

confidence: 99%

In Memoriam: Hector R. Wong, MD (1963–2022)

Varisco

2022

Pediatric Critical Care Medicine

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after which time he served as Vice Chair.Hector was passionate about improving the care of critically ill patients and promoting excellence and equity in the PICU and beyond. He authored over 200 manuscripts, largely focused on pediatric critical illness, and served as both Senior Associate Editor and Senior Editor of Pediatric Critical Care Medicine. He was a driving force behind the 2020 Surviving Sepsis Guidelines (1) and a stalwart of NIH study sections and special emphasis panels. A fellow of the American College of Critical Care Medicine, recipient of multiple Presidential Citations from the Society of Critical Care Medicine, and consistently selected as one of the "Best Doctors in America," Hector was a physician to be emulated. In him, junior faculty, trainees, patients, nurses, and families found patience, compassion, an impeccable bedside manner, and the healthy skepticism that is so foundational to clinical excellence in the PICU. As Interim Chair, he missed working in the PICU and eagerly returned to clinical care when he became Vice Chair in November 2020. In his various leadership roles, Dr. Wong served as a tireless advocate for the advancement of women and minorities. As Jamilah Hackworth, the associate director for Academic Affairs and Career Development at Cincinnati Children's Hospital recounted, "He regularly attended Black Faculty and Staff Alliance (BFSA) meetings and always made himself available to discuss and help resolve any challenge that underrepresented minority faculty members may have been experiencing. " As Interim Chair and Vice Chair, he invested in programs and structures aimed at addressing the inequities and disparities at the faculty, fellow, resident, staff, patient, and community levels and served as a role model of inclusivity.

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Biomarkers associated with mortality in pediatric patients with cardiac arrest and acute respiratory distress syndrome

Cited by 4 publications

References 53 publications

Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

The Childhood Acute Illness and Nutrition (CHAIN) network nested case-cohort study protocol: a multi-omics approach to understanding mortality among children in sub-Saharan Africa and South Asia

In Memoriam: Hector R. Wong, MD (1963–2022)

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