Advances in structural and functional genomics have paved the way for precision medicine in critically ill children. Patients with congenital heart disease are especially susceptible to various critical pathophysiologic states as they navigate the challenges of palliative and reparative cardiac surgeries. In addition to the stress of cardiopulmonary bypass, they also experience sepsis and acute respiratory distress syndrome which contributes to the overall morbidity and mortality. Enhanced understanding of the genomic mechanisms associated with these critical illnesses can lead to future research aiding the development of a personalized care management approach for this high-risk subgroup of critically ill children.
Precision Medicine; Pediatric Cardiac Intensive Care; Cardiac Intensive Care; Cardiac Intensive Care Unit
Precision medicine and genomics have changed the way we treat and stratify adults and children in the intensive care unit (ICU). With the advances in computational analytics, data mining, and cost reduction the use of genomics in heterogeneous diseases like sepsis and acute respiratory distress syndrome (ARDS) have shown promising results. Although up to 30% of children with congenital heart disease (CHD) have an underlying structural genetic disorder, there are limited functional genomic studies involving children with CHD when critically ill. In this commentary, we will discuss how functional genomics have advanced the pathophysiologic understanding of cardiopulmonary bypass (CPB), sepsis, ARDS, and future directions.