Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary
Authors: Bembea Melania M. , Agus Michael , Akcan-Arikan Ayse , Alexander Peta , Basu Rajit , Bennett Tellen D. , Bohn Desmond , Brandão Leonardo R. , Brown Ann-Marie , Carcillo Joseph A. , Checchia Paul , Cholette Jill , Cheifetz Ira M. , Cornell Timothy , Doctor Allan , Eckerle Michelle , Erickson Simon , Farris Reid W.D. , Faustino E. Vincent S. , Fitzgerald Julie C. , Fuhrman Dana Y. , Giuliano John S. , Guilliams Kristin , Gaies Michael , Gorga Stephen M. , Hall Mark , Hanson Sheila J. , Hartman Mary , Hassinger Amanda B. , Irving Sharon Y. , Jeffries Howard , Jouvet Philippe , Kannan Sujatha , Karam Oliver , Khemani Robinder G. , Kissoon Niranjan , Lacroix Jacques , Laussen Peter , Leclerc Francis , Lee Jan Hau , Leteurtre Stephane , Lobner Katie , McKiernan Patrick J. , Menon Kusum , Monagle Paul , Muszynski Jennifer A. , Odetola Folafoluwa , Parker Robert , Pathan Nazima , Pierce Richard W. , Pineda Jose , Prince Jose M. , Robinson Karen A. , Rowan Courtney M. , Ryerson Lindsay M. , Sanchez-Pinto L. Nelson , Schlapbach Luregn J. , Selewski David T. , Shekerdemian Lara S. , Simon Dennis , Smith Lincoln S. , Squires James E. , Squires Robert H. , Sutherland Scott M. , Ouellette Yves , Spaeder Michael C. , Srinivasan Vijay , Steiner Marie E. , Tasker Robert C. , Thiagarajan Ravi , Thomas Neal , Tissieres Pierre , Traube Chani , Tucci Marisa , Typpo Katri V. , Wainwright Mark S. , Ward Shan L. , Watson R. Scott , Weiss Scott , Whitney Jane , Willson Doug , Wynn James L. , Yeyha Nadir , Zimmerman Jerry J. 
Published: December 2021

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.