PROJECT SUMMARY/ABSTRACT – University of Michigan Pediatric Critical Care Medicine incorporates a multidisciplinary approach to address the medical needs of the most fragile population of critically ill and injured children. While current mortality rates at most academic, tertiary care children’s hospitals are below 5%, certain disease processes, notably sepsis and acute respiratory distress syndrome which are often accompanied with the presence of multiple organ dysfunction syndrome (MODS), remain associated with significantly higher mortality rates and utilize substantial health care resources. Despite this, the occurrences of these most challenging diseases do not occur sufficiently often at any one center to enable an effective, single-site study that will advance both our understanding and management of these diseases. Mindful of this reality, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) demonstrated great insight and vision in funding an infrastructure to create a multi-center research network, the Collaborative Pediatric Critical Care Research Network (CPCCRN). Our Pediatric Critical Care program at the University of Michigan, and the division Critical Care Medicine at the Children’s Hospital of Wisconsin and the Medical College of Wisconsin (MCW) who will participate as our ancillary site, have the infrastructure to allow us to actively participate in a number of multi-site studies. In addition to possessing this infrastructure, we also believe both sites have a team of investigators who can make important scientific and leadership contributions to the field. As a result, we are applying to participate within CPCCRN as a Clinical Site to assist in executing a large clinical trial investigating the efficacy of GM-CSF in critically ill children with sepsis entitled, Personalized Immunomodulation in Sepsis-induced MODS. We have the infrastructure and intellectual capacity to contribute in a meaningful way to the on-going growth and success of this research network that is committed to improving both the short- and long-term outcomes of critically ill and injured children. The goals of this proposal are for the Division of Pediatric Critical Care Medicine at the University of Michigan and our partner ancillary site, the Division of Pediatric Critical Care Medicine at the Medical College of Wisconsin to collaborate fully with the Executive Committee, the Data Coordinating Center and the other CPCCRN sites. In combination with our partner ancillary site, our site will provide access to over 100 PICU beds with over 4500 annual admissions, enabling us to participate fully in the “Personalized Immunomodulation in Sepsis-induced MODS” trial described in the overall component of this application. Our site proposal has three specific aims to achieve these goals: 1) to actively collaborate in implementation of the Collaborative Pediatric Critical Care Research Network clinical trial, 2) to provide opportu...