Pediatric septic shock treatment: new clues from genomic profiling

Abstract

Septic shock continues to be an important pediatric public health problem worldwide [1]. In the USA alone there are approximately 42,000 cases of pediatric septic shock per year, with a mortality rate of approximately 10% [2,3]. While this mortality rate is less than that of the adult population, it nonetheless translates to more than 4000 childhood deaths per year, thus highlighting the need for developing novel therapies and approaches specifically targeted for children suffering from septic shock. Current standard-ofcare for pediatric septic shock is limited to effective vaccination programs (i.e., prevention), antibiotics and physiologic support in modern pediatric intensive care units [1,4]. Relative to that of other pediatric diseases, and adult septic shock, there has been a paucity of meaningful translational research efforts in the field of pediatric septic shock, an unfortunate circumstance stemming from several factors. First, there is limited funding specifically earmarked for pediatric septic shock compared with other pediatric diseases (e.g., childhood cancer). Second and highly related, there is no high-profile organization specifically dedicated to fund raising and generating public awareness for pediatric septic shock akin to that of other childhood diseases such as cancer, cystic fibrosis or juvenile arthritis. Third, there has been a tendency in the field of pediatric critical care to adapt advances made in adult-based critical care medicine to children without direct, formal, efficacy data in children. While this ‘filter down’ approach is likely to be valid and appropriate under certain circumstances, the potential fallacy of this approach was recently