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儿童多器官功能障碍综合征的流行病学及转归

Epidemiology and Outcomes of Pediatric Multiple Organ Dysfunction Syndrome.

作者信息

Watson R Scott, Crow Sheri S, Hartman Mary E, Lacroix Jacques, Odetola Folafoluwa O

机构信息

1Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA. 2Division of Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA. 3Division of Pediatric Critical Care Medicine, Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Mayo Eugenio Litta Children's Hospital, Rochester, MN. 4Division of Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO. 5Division of Pediatric Critical Care Medicine, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada. 6Child Health Evaluation and Research Unit, Division of Pediatric Critical Care, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI.

出版信息

Pediatr Crit Care Med. 2017 Mar;18(3_suppl Suppl 1):S4-S16. doi: 10.1097/PCC.0000000000001047.

Abstract

OBJECTIVE

To summarize the epidemiology and outcomes of children with multiple organ dysfunction syndrome as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development multiple organ dysfunction syndrome workshop (March 26-27, 2015).

DATA SOURCES

Literature review, research data, and expert opinion.

STUDY SELECTION

Not applicable.

DATA EXTRACTION

Moderated by an experienced expert from the field, issues relevant to the epidemiology and outcomes of children with multiple organ dysfunction syndrome were presented, discussed, and debated with a focus on identifying knowledge gaps and research priorities.

DATA SYNTHESIS

Summary of presentations and discussion supported and supplemented by the relevant literature.

CONCLUSIONS

A full understanding the epidemiology and outcome of multiple organ dysfunction syndrome in children is limited by inconsistent definitions and populations studied. Nonetheless, pediatric multiple organ dysfunction syndrome is common among PICU patients, occurring in up to 57% depending on the population studied; sepsis remains its leading cause. Pediatric multiple organ dysfunction syndrome leads to considerable short-term morbidity and mortality. Long-term outcomes of multiple organ dysfunction syndrome in children have not been well studied; however, studies of adults and children with other critical illnesses suggest that the risk of long-term adverse sequelae is high. Characterization of the long-term outcomes of pediatric multiple organ dysfunction syndrome is crucial to identify opportunities for improved treatment and recovery strategies that will improve the quality of life of critically ill children and their families. The workshop identified important knowledge gaps and research priorities intended to promote the development of standard definitions and the identification of modifiable factors related to its occurrence and outcome.

摘要

目的

作为尤妮斯·肯尼迪·施莱佛国家儿童健康与人类发展研究所多器官功能障碍综合征研讨会(2015年3月26 - 27日)的一部分,总结儿童多器官功能障碍综合征的流行病学及转归情况。

数据来源

文献综述、研究数据及专家意见。

研究选择

不适用。

数据提取

由该领域一位经验丰富的专家主持,针对儿童多器官功能障碍综合征的流行病学及转归相关问题进行了展示、讨论和辩论,重点在于找出知识空白及研究重点。

数据综合

由相关文献支持和补充的展示内容及讨论总结。

结论

由于定义不一致以及所研究的人群不同,对儿童多器官功能障碍综合征的流行病学及转归的全面理解受到限制。尽管如此,儿童多器官功能障碍综合征在儿科重症监护病房(PICU)患者中很常见,根据所研究的人群不同,发生率高达57%;脓毒症仍然是其主要病因。儿童多器官功能障碍综合征会导致相当高的短期发病率和死亡率。儿童多器官功能障碍综合征的长期转归尚未得到充分研究;然而,对患有其他危重病的成人和儿童的研究表明,长期不良后遗症的风险很高。明确儿童多器官功能障碍综合征的长期转归对于确定改善治疗和康复策略的机会至关重要,这些策略将提高危重病儿童及其家庭的生活质量。该研讨会确定了重要的知识空白和研究重点,旨在促进标准定义的制定以及确定与其发生和转归相关的可改变因素。

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