It Seems Like the Resuscitation Happened Ages Ago—Chronic Critical Illness in Children

Fink, Ericka L.; Kochanek, Patrick M.

doi:10.1097/ccm.0000000000001100

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…A growing body of scholarship is drawing attention to the changing nature of pediatric critical care. 2,14,30,31 Multifaceted, longitudinal care of a child with PCCI requires a different mindset and approach than the care of a previously well but acutely ill child. [32][33][34] Their care often requires more attention to chronic issues and problems than acute care interventions, coordinating longitudinal decisions with various stakeholders, and working to align goals of care with parents, all of which require an immense amount of time, energy, and investment in the child's full scope of care to do well.…”

Section: Discussionmentioning

confidence: 99%

A Snapshot of Chronic Critical Illness in Pediatric Intensive Care Units

Shapiro

Boss

Donohue

et al. 2021

J Pediatr Intensive Care

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Children with chronic critical illness (CCI) represent the sickest subgroup of children with medical complexity. In this article, we applied a proposed definition of pediatric CCI to assess point prevalence in medical, cardiovascular, and combined pediatric intensive care units (PICUs), screening all patients admitted to six academic medical centers in the United States on May 17, 2017, for pediatric CCI (PCCI) eligibility. We gathered descriptive data to understand medical complexity and resource needs of children with PCCI in PICUs including data regarding hospitalization characteristics, previous admissions, medical technology, and chronic multiorgan dysfunction. Descriptive statistics were used to characterize the study population and hospital data. The study cohort was divided between PICU-prolonged (stay > 14 days) and PICU-exposed (any time in PICU); comparative analyses were conducted. On the study day, 185 children met inclusion criteria, 66 (36%) PICU-prolonged and 119 (64%) PICU-exposed. Nearly all had home medical technology and most (n = 152; 82%) required mechanical ventilation in the PICU. The PICU-exposed cohort mirrored the PICU-prolonged with a few exceptions as follows: they were older, had fewer procedures and surgeries, and had more recurrent hospitalizations. Most (n = 44; 66%) of the PICU-prolonged cohort had never been discharged home. Children with PCCI were a sizable proportion of the unit census on the study day. We found that children with PCCI are a prevalent population in PICUs. Dividing the cohorts between PICU-prolonged and PICU-exposed helps to better understand the care needs of the PCCI population. Identifying and studying PCCI, including variables relevant to PICU-prolonged and PICU-exposed, could inform changes to PICU care models and training programs to better enable PICUs to meet their unique needs.

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Section: Discussionmentioning

confidence: 99%

A Snapshot of Chronic Critical Illness in Pediatric Intensive Care Units

Shapiro

Boss

Donohue

et al. 2021

J Pediatr Intensive Care

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“…Although the sickest among these children most likely represent the pediatric chronically critically ill (Fig 1), pediatric chronic critical illness (PCCI) has received little systematic attention. [12][13][14][15] This subject is a missed opportunity to apply what we have learned about adult CCI to the care of infants and children.…”

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confidence: 99%

Defining Pediatric Chronic Critical Illness for Clinical Care, Research, and Policy

Shapiro

Henderson

Hutton

et al. 2017

Hospital Pediatrics

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Chronically critically ill pediatric patients represent an emerging population in NICUs and PICUs. Chronic critical illness has been recognized and defined in the adult population, but the same attention has not been systematically applied to pediatrics. This article reviews what is currently known about pediatric chronic critical illness, highlighting the unique aspects of chronic critical illness in infants and children, including specific considerations of prognosis, outcomes, and decision-making. We propose a definition that incorporates NICU versus PICU stays, recurrent ICU admissions, dependence on life-sustaining technology, multiorgan dysfunction, underlying medical complexity, and the developmental implications of congenital versus acquired conditions. We propose a research agenda, highlighting existing knowledge gaps and targeting areas of improvement in clinical care, research, and policy.

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Integrating Fragility Into Daily Life, the Emerging New Essence of Pediatric Intensive Care?*

Agbeko¹

2017

Pediatric Critical Care Medicine

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It Seems Like the Resuscitation Happened Ages Ago—Chronic Critical Illness in Children

Cited by 4 publications

References 14 publications

A Snapshot of Chronic Critical Illness in Pediatric Intensive Care Units

A Snapshot of Chronic Critical Illness in Pediatric Intensive Care Units

Defining Pediatric Chronic Critical Illness for Clinical Care, Research, and Policy

Integrating Fragility Into Daily Life, the Emerging New Essence of Pediatric Intensive Care?*

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