Multiple Organ Dysfunction Syndrome

Ramírez, Michelle

doi:10.1016/j.cppeds.2013.10.003

Cited by 70 publications

(53 citation statements)

References 32 publications

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“…There are various definitions given for this syndrome. These include “the development of potentially reversible physiologic derangement involving two or more organ systems not involved in the disorder that resulted in ICU admission, and arising in the wake of a potentially life‐threatening physiologic insult”; “the derangements of cardiovascular, pulmonary, renal, neurologic, coagulation, gastrointestinal (GI) and hepatic function in response to SIRS or sepsis”; and “the presence of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention” . It is clear, by any one of these definitions, that complicated B rossi infection results in this syndrome.…”

Section: Discussionmentioning

confidence: 99%

Disease severity and blood cytokine concentrations in dogs with natural Babesia rossi infection

Leisewitz

Goddard

Gier

et al. 2019

Parasite Immunology

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Aims Babesia rossi causes severe disease in dogs. Here, we describe the association between serum cytokine concentrations and disease severity. Methods Seventeen controls and 55 PCR confirmed B rossi‐infected dogs were included. Diseased dogs were subdivided into 23 critically ill and 32 relatively well cases. Serum concentrations of 11 cytokines and biochemical markers of disease severity were determined. Results Significant differences were detected for IL‐6, IL‐8, IL‐10, MCP‐1 and TNF‐α between the groups. Generally, the more complicated the disease, the more pro‐inflammatory the cytokine milieu. IL‐8 showed a reverse trend and was negatively correlated with disease severity. IL‐6, MCP‐1 and TNF‐α were also significantly higher in the dogs that died (n = 9) compared to the dogs that survived (n = 46). IL‐8 showed the opposite. MCP‐1 and TNF‐α were negatively correlated with biochemical markers of severity. Glucose was negatively correlated with IL‐6. Cortisol, peripheral parasite density and band neutrophil count were positively correlated, whilst thyroid hormone was negatively correlated with IL‐6, MCP‐1 and TNF‐α. Conclusions As in malaria and sepsis, B rossi infection induces a pro‐inflammatory cytokine storm that correlates with disease severity and adverse outcome. The multiplicity of cytokines involved argues for redundancy in the system once the disease is established.

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Section: Discussionmentioning

confidence: 99%

Disease severity and blood cytokine concentrations in dogs with natural Babesia rossi infection

Leisewitz

Goddard

Gier

et al. 2019

Parasite Immunology

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“…(2) A dysregulated immune response or immune paralysis in which homeostasis between the pro-inflammatory and anti-inflammatory reactions is lost is thought to be key in the development of MODS. (3) For instance, the IL-8 levels are clearly associated with worsened organ dysfunction within 24 hours. (4) …”

Section: Introductionmentioning

confidence: 99%

Prevalence of multiple organ dysfunction in the pediatric intensive care unit: Pediatric Risk of Mortality III versus Pediatric Logistic Organ Dysfunction scores for mortality prediction

Hamshary

Sherbini

El-Gebaly

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectivesTo assess the frequency of primary multiple organ failure and the role of sepsis as a causative agent in critically ill pediatric patients; and calculate and evaluate the accuracy of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Logistic Organ Dysfunction (PELOD) scores to predict the outcomes of critically ill children.MethodsRetrospective study, which evaluated data from patients admitted from January to December 2011 in the pediatric intensive care unit of the Children's Hospital of the University of Cairo.ResultsOut of 237 patients in the study, 72% had multiple organ dysfunctions, and 45% had sepsis with multiple organ dysfunctions. The mortality rate in patients with multiple organ dysfunction was 73%. Independent risk factors for death were mechanical ventilation and neurological failure [OR: 36 and 3.3, respectively]. The PRISM III score was more accurate than the PELOD score in predicting death, with a Hosmer-Lemeshow X2 (Chi-square value) of 7.3 (df = 8, p = 0.5). The area under the curve was 0.723 for PRISM III and 0.78 for PELOD.ConclusionA multiple organ dysfunctions was associated with high mortality. Sepsis was the major cause. Pneumonia, diarrhea and central nervous system infections were the major causes of sepsis. PRISM III had a better calibration than the PELOD for prognosis of the patients, despite the high frequency of the multiple organ dysfunction syndrome.

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“…Stage 2 or 3 AKI occurred in more than half of these children, indicating renal injury beyond simply prerenal azotemia. The occurrence of injuries to multiple organs, abnormal organ perfusion, and hyperinflammation suggests a pattern typical of multiple organ dysfunction syndrome . Whether DKA‐related brain injury might involve similar pathophysiology should be further investigated.…”

Section: The Pecarn Fluid Trialmentioning

confidence: 99%

Fluid treatment for children with diabetic ketoacidosis: How do the results of the pediatric emergency care applied research network Fluid Therapies Under Investigation in Diabetic Ketoacidosis (FLUID) Trial change our perspective?

Glaser

Kuppermann

2018

Pediatr Diabetes

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The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high‐quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). In June 2018, the results from the Fluid Therapies Under Investigation in DKA Trial conducted in the Pediatric Emergency Care Applied Research Network were published. This large, factorial‐designed randomized controlled trial assessed neurological outcomes of 1387 children with DKA who were treated with one of four fluid protocols that varied in infusion rate and sodium content. In this commentary, we review and discuss the results of this new study and the implications for clinical care of DKA in children.

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Multiple Organ Dysfunction Syndrome

Cited by 70 publications

References 32 publications

Disease severity and blood cytokine concentrations in dogs with natural Babesia rossi infection

Disease severity and blood cytokine concentrations in dogs with natural Babesia rossi infection

Prevalence of multiple organ dysfunction in the pediatric intensive care unit: Pediatric Risk of Mortality III versus Pediatric Logistic Organ Dysfunction scores for mortality prediction

Fluid treatment for children with diabetic ketoacidosis: How do the results of the pediatric emergency care applied research network Fluid Therapies Under Investigation in Diabetic Ketoacidosis (FLUID) Trial change our perspective?

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