监测多器官功能障碍综合征的严重程度:新的和进展性多器官功能障碍综合征、评分系统。
Monitoring Severity of Multiple Organ Dysfunction Syndrome: New and Progressive Multiple Organ Dysfunction Syndrome, Scoring Systems.
作者信息
Typpo Katri V, Lacroix Jacques R
机构信息
1Department of Pediatrics and the Steele Children's Research Center, University of Arizona College of Medicine, Tucson, AZ. 2Department of Pediatrics and Sainte-Justine Hospital, Université de Montréal, Montréal, QC, Canada.
出版信息
Pediatr Crit Care Med. 2017 Mar;18(3_suppl Suppl 1):S17-S23. doi: 10.1097/PCC.0000000000001049.
OBJECTIVE
To describe the diagnostic criteria of new and progressive multiple organ dysfunction syndrome and scoring systems that might be used to assess and monitor the severity and progression of multiple organ dysfunction syndrome in children presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development MODS 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 monitoring of the severity of multiple organ dysfunction syndrome including new and progressive multiple organ dysfunction syndrome and scoring systems 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 relevant literature.
CONCLUSIONS
Many sets of diagnostic criteria of multiple organ dysfunction syndrome are presently available. All are useful, but their diagnostic and predictive value can be improved. Several types of diagnostic criteria are candidates to describe the severity and to monitor the progression of cases of multiple organ dysfunction syndrome, which include existing scores of organ dysfunction: Pediatric Logistic Organ Dysfunction, version 2, daily Pediatric Logistic Organ Dysfunction, version 2, organ failure-free days, etc. If a new set of diagnostic criteria of multiple organ dysfunction syndrome is created, its value must be validated. Furthermore, the epidemiology of multiple organ dysfunction syndrome based on these new diagnostic criteria must be compared with the epidemiology found with the preexisting sets of diagnostic criteria. The reliability as well as the added values of additional or new candidate markers of organ dysfunction and multiple organ dysfunction syndrome severity must be studied and compared.
目的
描述新发性和进行性多器官功能障碍综合征的诊断标准以及可能用于评估和监测多器官功能障碍综合征严重程度和进展的评分系统,该综合征是作为尤妮斯·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)的一部分呈现的儿童疾病。
数据来源
文献综述、研究数据和专家意见。
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,提出、讨论并辩论了与多器官功能障碍综合征严重程度监测相关的问题,包括新发性和进行性多器官功能障碍综合征以及评分系统,重点是识别知识空白和研究重点。
数据综合
由相关文献支持和补充的报告及讨论总结。
结论
目前有许多套多器官功能障碍综合征的诊断标准。所有这些标准都有用,但它们的诊断和预测价值可以提高。有几种类型的诊断标准可用于描述多器官功能障碍综合征病例的严重程度并监测其进展,其中包括现有的器官功能评分:儿科逻辑器官功能障碍第2版、每日儿科逻辑器官功能障碍第2版、无器官衰竭天数等。如果创建一套新的多器官功能障碍综合征诊断标准,其价值必须经过验证。此外,基于这些新诊断标准的多器官功能障碍综合征的流行病学情况必须与使用先前诊断标准所发现的流行病学情况进行比较。必须研究并比较器官功能障碍和多器官功能障碍综合征严重程度的其他候选标志物或新候选标志物的可靠性以及附加值。