Archive | 2019
Multiple Organ Dysfunction in the Pediatric Intensive Care Unit
Abstract
Abstract Pediatric multiple organ dysfunction syndrome (MODS) has a blurred epidemiology, ranging from 10% to 50% of children admitted to the pediatric intensive care unit, mostly depending on critical illness diagnosis, the presence of sepsis, history of chronic diseases, and patients age (the neonates being at highest risk). An unbalanced immune response in the homeostasis between proinflammatory and antiinflammatory mediators is thought to be the cause for the development of MODS. Lungs are most often the first organ initiating the MODS cascade. Heart, brain, kidney, and liver are the other typically involved components of MODS. Specific pediatric MODS conditions are represented by thrombocytopenia-associated multiple organ failure, hemophagocytic lymphohistiocytosis, Kawasaki syndrome, and several pictures linked to hematologic malignancies pathogenesis and management complications. Management of pediatric MODS requires a multimodal approach and depends primarily on initial diagnosis. It includes aggressive ventilatory and hemodynamic support, prevention of renal damage, and the administration of immunosuppressive agents in selected cases. The indications for Extracorporeal membrane oxygenation and extracorporeal life support recently have increased, and more timely interventions currently may be suggested.