Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.
Melania M. Bembea, Michael S. D. Agus, Ayse Akcan‐Arikan, Peta Alexander, Rajit K. Basu, Tellen D. Bennett, Desmond Bohn, Leonardo R. Brandão, Ann‐Marie Brown, Joseph A. Carcillo, Paul A. Checchia, Jill M. Cholette, Ira M. Cheifetz, Timothy T. Cornell, Allan Doctor, Michelle Eckerle, Simon Erickson, Reid Farris, E. Vincent S. Faustino, Julie C. Fitzgerald, Dana Y. Fuhrman, John S. Giuliano, Kristin P. Guilliams, Michael Gaies, Stephen M. Gorga, Mark W. Hall, Sheila J. Hanson, Mary E. Hartman, Amanda Hassinger, Sharon Y. Irving, Howard E. Jeffries, Philippe Jouvet, Sujatha Kannan, Oliver Karam, Robinder G. Khemani, Niranjan Kissoon, Jacques Lacroix, Peter C. Laussen, Francis Leclerc, Jan Hau Lee, Stéphane Leteurtre, Katie Lobner, Patrick McKiernan, Kusum Menon, Paul Monagle, Jennifer A. Muszynski, Folafoluwa O. Odetola, Robert I. Parker, Nazima Pathan, Nazima Pathan, Richard W. Pierce, Jose Pineda, José M. Prince, Karen A. Robinson, Courtney M. Rowan, Lindsay M. Ryerson, L. Nelson Sanchez‐Pinto, Luregn J. Schlapbach, David T. Selewski, Lara Shekerdemian, Dennis Simon, Lincoln Smith, James E. Squires, Robert H. Squires, Scott M. Sutherland, Yves Ouellette, Michael C. Spaeder, Vijay Srinivasan, Marie E. Steiner, Robert C. Tasker, Ravi R. Thiagarajan, Neal J. Thomas, Pierre Tissières, Chani Traube, Marisa Tucci, Katri Typpo, Mark S. Wainwright, Shan L. Ward, R. Scott Watson, Scott L. Weiss, Jane Whitney, Doug Willson, James L. Wynn, Yehya, Nadir, Jerry J. Zimmerman
Abstract
Prior criteria for organ dysfunction in critically ill children were based mainly on expert opinion. We convened the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) expert panel to summarize data characterizing single and multiple organ dysfunction and to derive contemporary criteria for pediatric organ dysfunction. The panel was composed of 88 members representing 47 institutions and 7 countries. We conducted systematic reviews of the literature to derive evidence-based criteria for single organ dysfunction for neurologic, cardiovascular, respiratory, gastrointestinal, acute liver, renal, hematologic, coagulation, endocrine, endothelial, and immune system dysfunction. We searched PubMed and Embase from January 1992 to January 2020. Study identification was accomplished using a combination of medical subject headings terms and keywords related to concepts of pediatric organ dysfunction. Electronic searches were performed by medical librarians. Studies were eligible for inclusion if the authors reported original data collected in critically ill children; evaluated performance characteristics of scoring tools or clinical assessments for organ dysfunction; and assessed a patient-centered, clinically meaningful outcome. Data were abstracted from each included study into an electronic data extraction form. Risk of bias was assessed using the Quality in Prognosis Studies tool. Consensus was achieved for a final set of 43 criteria for pediatric organ dysfunction through iterative voting and discussion. Although the PODIUM criteria for organ dysfunction were limited by available evidence and will require validation, they provide a contemporary foundation for researchers to identify and study single and multiple organ dysfunction in critically ill children.