An enhanced understanding of the sepsis pathophysiology that drives multiple organ dysfunction (MODS) needs to be better established and potential therapeutic targets need to be identified.
A better understanding of the influence that pulmonary and immune system maturation have on the pathophysiology of acute respiratory distress syndrome (ARDS) needs to be established with an attempt to explain the differences between children and adults in terms of outcomes and the occurrence of MODS associated with ARDS.
The impact of age on the occurrence of MODS following cardiac surgery and cardiopulmonary bypass needs to be better established. Moreover, similarities and differences between MODS in the setting of cardiac repair and other etiologies such as sepsis and trauma need to be elucidated; such study may improve outcomes in each of these settings.
Established triggers of MODS with well-defined timelines such as cardiopulmonary bypass and anti-neoplastic therapy need to be used as models for studying MODS. The conditions associated with these interventions such as congenital heart and cancer represent opportunities for long-term follow up of MODS and the impact of multiple insults.
The role of anti-cytokine therapy in conditions associated with MODS needs to be determined. However, to do so, mediating biomarkers must first be identified that can be assessed in a clinically relevant time frame as has been accomplished for the cytokine release syndrome.
Mortality among pediatric hematopoietic stem cell patients remains unacceptably high and there is a clear association of mortality with MODS in this patient population. In order to advance this field, early predictors of patient at risk need to be identified. The development of novel strategies that reduce transplant-related toxicity in combination with the discovery of biomarkers that may predict the development, severity and response to therapy of these complications must be further established.
