Unable to collect a cumulative total of 20.5 mL of blood for this study due to research blood draw limits; OR

Limitation of care order at the time of screening; OR

Patients at high risk for brain death; OR

Active (or planned within 7 days) immunosuppressive treatment for oncologic, transplant, or rheumatologic disease; OR

Known primary immunodeficiency disorder; OR

Diagnosis of myeloid leukemia, myelodysplasia, or autoimmune thrombocytopenia;OR

Known allergy to GM-CSF; OR

Documented hyperferritinemia (serum ferritin \>= 500 ng/ml) during current sepsis event; OR

Contraindication to SQ injection (ECMO); OR

Burns where \>5% of the total body surface area is affected; OR

Renal replacement therapy at the time of screening; OR

On ECMO or anticipated to require ECMO; OR

Known pregnancy; OR

Inability to collect and ship sample for immune testing on MODS Day 2; OR

Previous enrollment in the GRACE study

GM-CSF for Reversal of immunopAralysis in pediatriC sEpsis-induced MODS Study