Research to Advance the Understanding and Management of the Multiple Organ Dysfunction Syndrome in Children (R01 Clinical Trial Optional) | PAR 18 091

Opportunity Information: Apply for PAR 18 091

The National Institutes of Health (NIH) funding opportunity PAR-18-091, titled "Research to Advance the Understanding and Management of the Multiple Organ Dysfunction Syndrome in Children (R01 Clinical Trial Optional)," supports a broad research program aimed at improving how pediatric multiple organ dysfunction syndrome (MODS) is understood, prevented, monitored, and treated. MODS is a major driver of illness and death in critically ill children, and this FOA is built around the idea that progress has been limited by gaps in fundamental knowledge about why MODS develops, how it evolves over time, and which interventions meaningfully change outcomes. The announcement encourages studies that generate foundational insights as well as studies that translate those insights into better clinical management strategies, with the ultimate goal of reducing morbidity and mortality and improving recovery trajectories for children affected by MODS.

A central theme of the FOA is that MODS in children is complex and can arise from multiple initiating insults and disease contexts, so NIH is interested in research that spans a wide range of clinical scenarios and biological mechanisms. Proposed projects can address epidemiology (such as incidence, risk factors, and outcome patterns across populations), pathophysiology (mechanistic work on immune dysregulation, endothelial injury, mitochondrial dysfunction, organ cross-talk, or other relevant biology), monitoring and diagnostics (including biomarkers, physiologic monitoring, and risk stratification tools), and therapeutics (from supportive care optimization to targeted interventions). Importantly, the FOA explicitly encourages studies that focus on specific etiologies or clinical settings commonly associated with pediatric MODS, including sepsis, trauma, acute respiratory distress syndrome, inborn errors of metabolism, burns, cancer and cancer therapy complications, transplantation, and congenital heart disease. This emphasis signals that NIH is looking both for unifying MODS mechanisms across conditions and for context-specific insights that can drive tailored prevention and treatment approaches.

The scope of acceptable study designs is intentionally wide, reflecting the need for both discovery science and clinical validation. Applications may range from basic science and animal models, to exploratory and longitudinal human studies, to prospective randomized controlled trials. The "clinical trial optional" designation means applicants may propose clinical trials when appropriate, but they are not required to do so; strong non-trial mechanistic, observational, or translational projects are also responsive. This flexibility is meant to support a coherent pipeline of research, where early-stage mechanistic work can identify targets or phenotypes, longitudinal cohorts can clarify trajectories and heterogeneity, and interventional studies can test whether new approaches actually prevent MODS, shorten its course, or improve long-term outcomes.

From an administrative standpoint, this is an NIH discretionary grant mechanism using the R01 funding instrument, categorized under Health, Income Security and Social Services, with CFDA number 93.865. The funding opportunity was created on November 6, 2017, and the original closing date listed is May 7, 2019. The excerpted source data does not provide an award ceiling or expected number of awards, which typically means applicants should consult the full FOA text and NIH institute-specific guidance for budget expectations, project period norms, and any institute priorities tied to pediatric critical care and MODS.

Eligibility is broad and includes many organizational types, reflecting NIH interest in drawing expertise from pediatric hospitals, universities, research institutes, and community or specialty organizations. Eligible applicants include state, county, city, township, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations other than federally recognized governments; public housing authorities/Indian housing authorities; nonprofits with and without 501(c)(3) status (other than institutions of higher education); for-profit organizations other than small businesses; and small businesses. The FOA also highlights additional eligible applicant categories, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), eligible federal agencies, faith-based or community-based organizations, non-domestic (non-U.S.) entities/foreign organizations, regional organizations, Indian/Native American tribal governments other than federally recognized entities, and U.S. territories or possessions. Taken together, the eligibility language is designed to encourage diverse participation and cross-institutional collaboration, which is often essential for pediatric MODS research given the need for adequate sample sizes, specialized critical care infrastructure, and multidisciplinary expertise.

Overall, the opportunity is best understood as an invitation to build and strengthen the pediatric MODS evidence base across the full research spectrum: defining and measuring MODS more precisely, identifying mechanistic drivers and distinct patient subgroups, improving early detection and monitoring, and testing interventions that can prevent organ failure progression or improve recovery. NIH is signaling that impactful applications will not only describe MODS but will push toward actionable understanding, whether by clarifying causal pathways, validating clinically useful biomarkers or phenotypes, optimizing supportive care strategies, or evaluating novel therapies in rigorous preclinical or clinical frameworks.

• The National Institutes of Health in the health, income security and social services sector is offering a public funding opportunity titled "Research to Advance the Understanding and Management of the Multiple Organ Dysfunction Syndrome in Children (R01 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.865.
• This funding opportunity was created on 2017-11-06.
• Applicants must submit their applications by 2019-05-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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