Long-stay children in intensive care

Namachivayam, Poongundran; Taylor, Anna; Montague, Terence; Moran, Karen; Barrie, Joanne; Delzoppo, Carmel; Butt, Warwick

doi:10.1097/pcc.0b013e31824fb989

Cited by 107 publications

(78 citation statements)

References 23 publications

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“…As a likely surrogate for severity of illness, LOS is consistently reported as a risk factor for unfavorable neurofunctional outcomes in PICU patients. Prolonged PICU admissions beyond 28 days are followed by moderate or severe disability as defined by a modified Glasgow Outcome Scale in as many as 67% of survivors (13). …”

Section: Neurologic Outcomes Following Picu Carementioning

confidence: 99%

Neurologic Outcomes Following Care in the Pediatric Intensive Care Unit

Caprarola

Kudchadkar

Bembea

2017

Curr Treat Options Peds

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Purpose of review With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients. Recent Findings Decline in neurofunctional status occurs in 3%–20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes. Recent research focuses on early identification and treatment of modifiable risk factors for unfavorable outcomes, and on long-term follow-up that moves beyond global cognitive outcomes and is increasingly including tests assessing multidimensional aspects of neurodevelopment. Summary The pediatric critical care research community has shifted focus from survival to survival with favorable neurologic outcomes of children admitted to the PICU.

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Section: Neurologic Outcomes Following Picu Carementioning

confidence: 99%

Neurologic Outcomes Following Care in the Pediatric Intensive Care Unit

Caprarola

Kudchadkar

Bembea

2017

Curr Treat Options Peds

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“…However, as Namachivayam, et al in this issue of the journal, 1 and other groups have pointed out, a growing part of our duty is to care for children who require prolonged stays to achieve PICU discharge. Accordingly, the Society for Critical Care Medicine defines chronic critical illness as a prolonged need for mechanical ventilation, whether in an ICU or not, in which the patient is not back to his or her prior functioning and remains at increased risk of mortality (http://www.myicucare.org/Adult-Support/Pages/Chronic-Critical-Illness.aspx).…”

mentioning

confidence: 99%

“…Research has shown that this group of patients requires special attention, as they consume a sizeable amount of resources and frequently have poor long-term health outcomes after PICU discharge. 1,2 …”

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confidence: 99%

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

Fink

Kochanek²

2015

Critical Care Medicine

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“…The median age of these patients was 4 months, and >70% of survivors had poor to very poor outcomes. (3) Approximately 90% of inpatient pediatric deaths occur in the ICU(2), often after withdrawal of life-prolonging medical therapy and accompanied by some degree of moral distress for caregivers and families. (1, 4)…”

mentioning

confidence: 99%

Integrating Palliative Care Into the PICU

Boss

Nelson

Weissman

et al. 2014

Pediatric Critical Care Medicine

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Objective This review highlights the benefits that patients, families and clinicians can expect to realize when palliative care service is intentionally incorporated into the PICU, focusing on pain and symptom management, enhancing quality of life, communication and decision-making, length of stay and sites of care, and grief and bereavement. Data Sources MEDLINE Data Synthesis and Conclusions The American Academy of Pediatrics suggests that palliative care should begin at the time of a potentially life-limiting diagnosis and continue throughout the disease trajectory, regardless of the expected outcome. Although the PICU is often used for short term postoperative stabilization, PICU clinicians also care for many chronically ill children with complex underlying conditions and others receiving intensive care for prolonged periods. Integrating palliative care delivery into the PICU is rapidly becoming the standard for high quality care of critically ill children. Interdisciplinary ICU staff can take advantage of the growing resources for continuing education in pediatric palliative care principles and interventions.

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Long-stay children in intensive care

Cited by 107 publications

References 23 publications

Neurologic Outcomes Following Care in the Pediatric Intensive Care Unit

Neurologic Outcomes Following Care in the Pediatric Intensive Care Unit

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

Integrating Palliative Care Into the PICU

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