medRxiv preprint doi: https://doi.org/10.1101/2020.02.15.20022772; this version posted February 20, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . 1 Gene expression signatures identify pediatric patients with multiple 2 organ dysfunction who require advanced life support in the intensive 3 care unit 4 Running title: Transcriptional signature for multiple organ dysfunction 5 syndrome trajectory 6 7 Rama Shankar (
[email protected])1,2, Mara L. Leimanis 8 (
[email protected])1,3, Patrick A. Newbury (
[email protected])1,2, Ke Liu 9 (
[email protected])1,2, Jing Xing (
[email protected])1,2, Derek Nedveck 10 (
[email protected]) 4, Eric J. Kort (
[email protected])1,5,6, Jeremy W 11 Prokop (
[email protected])1,2, Guoli Zhou (
[email protected])7, André S Bachmann 12 (
[email protected])1, Bin Chen (
[email protected])1,2*, Surender Rajasekaran 13 (
[email protected])1,3,4* 14 15 16 1 Depar tment of Pediatrics and Human Development, College of Human Medicine, Michigan State 17 University, Grand Rapids, MI 49503, USA 18 2 Depar tment of Pharmacology and Toxicology, College of Human Medicine, Michigan State University, 19 Grand Rapids, MI 49503, USA 20 3 Pediatr ic Intensive Care Unit, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, 21 MI, 49503, USA 22 4 Office of Resear ch, Spectrum Health, 15 Michigan Street NE, Grand Rapids, MI 49503, USA 23 5 DeV os Cardiovascular Program, Van Andel Research Institute and Fredrik Meijer Heart and Vascular 24 Institute/Spectrum Health, Grand Rapids, MI 49503, USA 25 6 Pediatr ic Hospitalist Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, 26 MI, 49503, USA 27 7 Biom edical Research Informatics Core (BRIC), Clinical and Translational Sciences Institute (CTSI), 28 Michigan State University, East Lansing, MI 48824, USA 29 30 * Cor respondence: Dr.