Gene expression signatures identify pediatric patients with multiple organ dysfunction who require advanced life support in the intensive care unit

Multiple organ dysfunction syndrome (MODS) can result from a variety of initiating events such as infection or trauma. The clinical condition of some MODS patients may deteriorate and require intense resource and high-risk cardiopulmonary support via extracorporeal membrane oxygenation (ECMO). Until now, no diagnostic criteria/molecular biomarker has been developed to identify MODS patients who require subsequent ECMO support. We used multi-time point (0h, 72h and 8d) whole transcriptomics from total blood of 27 patients (contro-4, MODS-17 and ECMO-6) to derived the molecular signatures to diagnose the MODS patients required ECMO support. We observed that immune response (neutrophil level) was compromised in MODS patients, who required ECMO support. Differential gene expression analysis and gene ontology enrichment has revealed that epigenetic modifications has got activated during the MODS deterioration to ECMO. In addition, signature of 6 genes were identified using logistic regression, which can be used as putative diagnostic markers for patients needed ECMO support. RNA was isolated from each samples using KAPA RNA HyperPrep Kit as per manufucturar description. Further, ribodepleted RNA was obtained from total RNA using ribominus kit. RNA-Seq library was generated for individual samples from the ribo-depleted RNA. Sequencing of library was done on illumine Nextera 500 sequencing platform. Raw data files were not provided due to patient privacy concerns.