title: Pediatric Multiple Organ Dysfunction Syndrome: Promising Therapies.
abstract: OBJECTIVE
  To describe the state of the science, identify knowledge gaps, and offer potential future research questions regarding promising therapies for children with multiple organ dysfunction syndrome presented during the Eunice Kennedy Shriver National Institute of Child Health and Human Development Workshop on Pediatric Multiple Organ Dysfunction Syndrome (March 26-27, 2015).
  
  
  METHODS
  Literature review, research data, and expert opinion.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Moderated by an expert from the field, issues relevant to the association of multiple organ dysfunction syndrome with a variety of conditions were presented, discussed, and debated with a focus on identifying knowledge gaps and research priorities.
  
  
  RESULTS
  Summary of presentations and discussion supported and supplemented by relevant literature.
  
  
  CONCLUSIONS
  Among critically ill children, multiple organ dysfunction syndrome is relatively common and associated with significant morbidity and mortality. For outcomes to improve, effective therapies aimed at preventing and treating this condition must be discovered and rigorously evaluated. In this article, a number of potential opportunities to enhance current care are highlighted including the need for a better understanding of the pharmacokinetics and pharmacodynamics of medications, the effect of early and optimized nutrition, and the impact of effective glucose control in the setting of multiple organ dysfunction syndrome. Additionally, a handful of the promising therapies either currently being implemented or developed are described. These include extracorporeal therapies, anticytokine therapies, antitoxin treatments, antioxidant approaches, and multiple forms of exogenous steroids. For the field to advance, promising therapies and other therapies must be assessed in rigorous manner and implemented accordingly.
authors.affiliation: 1Departments of Pediatrics (Critical Care Medicine) and Biochemistry, Washington University in St. Louis, St. Louis, MO. 2Department of Pediatrics (Critical Care Medicine), University of Washington, Seattle, WA. 3Department of Pediatrics (Critical Care Medicine), Harvard University, Boston, MA. 4Department of Pediatrics (Critical Care Medicine), Michigan State University, Grand Rapids, MI. 5Departments of Pediatrics (Critical Care Medicine) and Microbiology, University of Chicago, Chicago, IL. 6Department of Pediatrics (Critical Care Medicine), Emory University, Atlanta, GA. 7Obstetric and Pediatric Pharmacology and Therapeutics Branch, NICHD, Bethesda, MD. 8Department of Pediatrics (Critical Care Medicine), University of Arizona, Phoenix, AZ.
authors.forename: Allan
authors.initials: A
authors.lastname: Doctor
authors.forename: Jerry
authors.initials: J
authors.lastname: Zimmerman
authors.forename: Michael
authors.initials: M
authors.lastname: Agus
authors.forename: Surender
authors.initials: S
authors.lastname: Rajasekaran
authors.forename: Juliane
authors.initials: J
authors.lastname: Bubeck Wardenburg
authors.forename: James
authors.initials: J
authors.lastname: Fortenberry
authors.forename: Anne
authors.initials: A
authors.lastname: Zajicek
authors.forename: Emma
authors.initials: E
authors.lastname: Mairson
authors.forename: Katri
authors.initials: K
authors.lastname: Typpo
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D000992:Antitoxins / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D005112:Extracorporeal Circulation; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D009102:Multiple Organ Failure / Q000628:therapy*; D044623:Nutrition Therapy / Q000379:methods; D010372:Pediatrics; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D000992:Antitoxins; D007004:Hypoglycemic Agents; D013256:Steroids