Does critical illness and intensive care unit treatment contribute to neurocognitive and functional morbidity in pediatric patients?

Hopkins, Ramona O.

doi:10.2223/jped.1729

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Research is limited in the area of long-term cognitive impairment (LTCI) in pediatrics, however recent investigations using validated rating scales suggest that a significant percent of pediatric patients develop unfavorable neurocognitive and functional morbidity following critical illness 68. Alievi and colleagues69 assessed outcomes of 443 PICU survivors using validated functional outcome scales, finding that PICU treatment and critical illness contributed to considerable declines in neurocognitive and functional performance in a significant proportion of this study cohort.…”

Section: Prevalence and Prognostic Significancementioning

confidence: 98%

Delirium: An Emerging Frontier in the Management of Critically Ill Children

Smith

Fuchs

Pandharipande

et al. 2009

Critical Care Clinics

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1.Introduce pediatric delirium and provide understanding of acute brain dysfunction with its classification and clinical presentations. 2.Understand how delirium is diagnosed and discuss current modes of delirium diagnosis in the critically ill adult population and translation to pediatrics. 3.Understand the prevalence and prognostic significance of delirium in the adult and pediatric critically ill population. 4.Discuss the pathophysiology of delirium as currently understood. 5.Provide general management guidelines for delirium.

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Section: Prevalence and Prognostic Significancementioning

confidence: 98%

Delirium: An Emerging Frontier in the Management of Critically Ill Children

Smith

Fuchs

Pandharipande

et al. 2009

Critical Care Clinics

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“…(45–52) The long-term negative effects of critical illness and its care in children are undoubtedly more common than studies using only global outcome measures suggest, as specific sequelae, such as subtle but important changes in cognitive function, may go undiagnosed and untreated. (53–56)…”

Section: Health-related Quality Of Life Functional Status and Costsmentioning

confidence: 99%

Epidemiology and Outcomes of Pediatric Multiple Organ Dysfunction Syndrome

Watson

Crow

Hartman

et al. 2017

Pediatric Critical Care Medicine

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Objective To summarize the epidemiology and outcomes of children with multiple organ dysfunction syndrome (MODS), as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development MODS Workshop (March 26–27, 2015). Data Sources Literature review, research data, and expert opinion Study Selection Not applicable Data Extraction Moderated by an experienced expert from the field, issues relevant to the epidemiology and outcomes of children with MODS were presented, discussed and debated with a focus on identifying knowledge gaps and research priorities. Data Synthesis Summary of presentations and discussion supported and supplemented by relevant literature. Conclusions A full understanding the epidemiology and outcome of MODS in children is limited by inconsistent definitions and populations studied. Nonetheless, pediatric MODS is common among PICU patients, occurring in up to 57% depending on the population studied; sepsis remains its leading cause. Pediatric MODS leads to considerable short-term morbidity and mortality. Long-term outcomes of MODS in children have not been well studied; however, studies of adults and children with other critical illnesses suggest that the risk of long-term adverse sequelae is high. Characterization of the long-term outcomes of pediatric MODS is crucial to identify opportunities for improved treatment and recovery strategies that will improve the quality of life of critically ill children and their families. The Workshop identified important knowledge gaps and research priorities intended to promote the development of standard definitions and the identification of modifiable factors related to its occurrence and outcome.

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“…As survival rates in children improve and the utilization of pediatric critical care unit (PCCU) services continues to grow [22], it becomes increasingly important for clinicians to focus on outcomes beyond survival, to the prevention and management of potential complications of critical illness and critical care. Critical illness negatively impacts neurocognitive and functional recovery [22,29], and can result in substantial physical sequelae in children [30]. Therefore, the feasibility, safety and efficacy of acute rehabilitation and early mobilization within the PCCU setting need to be evaluated.…”

Section: Discussionmentioning

confidence: 99%

Acute rehabilitation in critically ill children

Choong

Tran

Clark

et al. 2015

J Pediatr Intensive Care

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Immobility increases morbidity, while early mobilization improves outcomes in adults. Rehabilitation practices in critically ill children, and the degree to which they are immobilized, are currently not well understood. The objective of this retrospective cohort study was to evaluate acute rehabilitation practices and potential barriers to mobilization in a tertiary care pediatric critical care unit (PCCU). Children aged less than 18 yr with a greater than 24 h length of stay were eligible. Outcomes of interest were physical therapy (PT) practice patterns, predictors of immobility, and adverse sequelae attributable to immobility. Interventions were classified as non-mobility and mobility types of PT. Ninety-one patients were included, 46.2% (42/91) were males. The mean age was 6.4 ? 6.4 yrs. Thirty-six of ninety-one (39.6%) patients received some form of PT while in PCCU. The mean proportion of PCCU days during which PT occurred was 20% (SD 28.8), and 3% (3/91) of patients received PT daily. Sixteen patients (17.6%) received exclusively non-mobility PT, 20 (22.0%) received some form of mobility, and six (6.6%) received both non-mobility and mobility PT. Increased severity of illness, mechanical ventilation, baseline disability and young age were identified barriers to mobilization. Immobilization is common in critically ill children. PT was often delayed until the patient was stabilized, and when performed was focused on respiratory function. Mobility PT was reserved for less sick, older, and non-mechanically ventilated patients. Future research is necessary to evaluate the significance of immobility and its impact on clinical outcomes in this population.

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Does critical illness and intensive care unit treatment contribute to neurocognitive and functional morbidity in pediatric patients?

Abstract: Cada vez mais, tem-se dado atenção à proposição de que a doença aguda pode trazer implicações adversas à função cognitiva e pode exercer um papel importante no desenvolvimento da deficiência cognitiva que atinge os adultos

Cited by 7 publications

References 13 publications

Delirium: An Emerging Frontier in the Management of Critically Ill Children

Delirium: An Emerging Frontier in the Management of Critically Ill Children

Epidemiology and Outcomes of Pediatric Multiple Organ Dysfunction Syndrome

Acute rehabilitation in critically ill children

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