367: Outcomes After Pediatric Intensive Care: First-Year Experience of a Picu Follow-Up Clinic

Pont‐Thibodeau, Geneviève Du; La, Kim-Anh; François, Tine; Gerardis, George; Harrington, Karen; Lacroix, Jacques; Roumeliotis, Nadia; Beauchamp, Miriam H.; Crevier, Lyne

doi:10.1097/01.ccm.0000619820.72273.4e

Cited by 3 publications

(1 citation statement)

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“…Understanding trajectories of recovery will assist us in planning for the optimal timing of interventions to minimize or mitigate PICS-p. There are numerous studies and clinical services currently underway which are already addressing some of these gaps (164)(165)(166)(167)(168)(169)(170)(171)(172). The results of these and others, will only help to further our understanding and progress the care of children and their families following critical illness.…”

Section: Knowledge Gaps and Future Directionsmentioning

confidence: 99%

Transitions from short to long-term outcomes in pediatric critical care: considerations for clinical practice

Long¹,

Fink²

2021

Transl Pediatr

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Most children are surviving critical illness in highly resourced pediatric intensive care units (PICUs). However, in research studies, many of these children survive with multi-domain health sequelae that has the potential to affect development over many years, termed post-intensive care syndrome-pediatrics (PICS-p). Clinically, there are no recommendations for the assessment and follow-up of children with critical illness as exists for the premature neonatal and congenital heart disease populations. In research studies, primary and secondary outcomes are largely assessed at or prior to hospital discharge, disregarding post-hospital outcomes important to PICU stakeholders. Incorporating longer term outcomes into clinical and research programs, however, can no longer be overlooked. Barriers to outcomes assessments are varied and generalized vs. individualized, but some PICU centers are discovering how to overcome them and are providing this service to families-sometimes specific populations-in need. Research programs and funders are increasingly recognizing the value and need to assess long-term outcomes post-PICU. Finally, we should seek the strong backing of the PICU community and families to insist that long-term outcomes become our new clinical standard of care. PICUs should consider development of a multicenter, multinational collaborative to assess clinical outcomes and optimize care delivery and patient and family outcomes. The aim of this review is to present the potential considerations of implementing long-term clinical follow-up following pediatric critical illness.

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Section: Knowledge Gaps and Future Directionsmentioning

confidence: 99%

Transitions from short to long-term outcomes in pediatric critical care: considerations for clinical practice

Long¹,

Fink²

2021

Transl Pediatr

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Co-Evolutions of Pediatric and Adult Critical Care

Parker

Thompson

Lumb

et al. 2021

Critical Care Medicine

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Paediatric intensive care follow‐up provision in the United Kingdom and Republic of Ireland

Manning

Scholefield

Popejoy

et al. 2020

Nursing in Critical Care

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The objective of this study was to examine the characteristic, content, and role of Paediatric Intensive Care Units (PICUs) in the provision of follow‐up for children and their families' post‐intensive care discharge in the United Kingdom (UK) and Republic of Ireland (RoI). The study followed a descriptive self‐reported, web‐based survey design. “In‐hospital PICU follow‐up” was defined as follow‐up delivered by the PICU team following PICU discharge but before hospital discharge and “post‐discharge PICU follow‐up” was defined as follow‐up delivered by the PICU team following hospital discharge. The survey was administered to all 28 PICUs in the UK and RoI. Paediatric intensive care medical directors or delegated individuals participated. Data were collected between September 2017 and January 2018 with a response rate of 79% (n = 22/28). Twelve units provided either in‐hospital and/or post‐discharge PICU follow‐up. Ten (45%) PICUs reported providing in‐hospital follow‐up, with half (n = 5) using an eligibility criteria for in‐hospital follow‐up, which related to disease groups. The most frequently reported form of in‐hospital PICU follow‐up consisted of face‐to‐face patient consultation (n = 8) by a PICU doctor (n = 5) and/or nurse (n = 4). The time at which initial contact was made was usually not predetermined (n = 4) and the assessment of care needs included are tracheostomy care (n = 4), respiratory care (n = 4), and sedative medication weaning plan (n = 5). Four PICUs reported to provide post‐discharge follow‐up. This involved telephone (n = 2), follow‐up clinic consultations (n = 1) or home visits (n = 1), provided predominantly by PICU doctors (n = 2), with their activity directed by patient needs (n = 3). Despite increasing evidence to suggest PICU survivors and their families experience negative sequalae post‐PICU discharge, less than half of PICUs surveyed provide in‐hospital follow‐up and only a minority provide post‐discharge follow‐up. There is variation in the delivery, content, and format of in‐hospital and post‐discharge PICU follow‐up in the UK and RoI.

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367: Outcomes After Pediatric Intensive Care: First-Year Experience of a Picu Follow-Up Clinic

Cited by 3 publications

References 0 publications

Transitions from short to long-term outcomes in pediatric critical care: considerations for clinical practice

Transitions from short to long-term outcomes in pediatric critical care: considerations for clinical practice

Co-Evolutions of Pediatric and Adult Critical Care

Paediatric intensive care follow‐up provision in the United Kingdom and Republic of Ireland

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