Functional Recovery in Critically Ill Children, the “WeeCover” Multicenter Study

Choong, Karen; Fraser, Douglas D.; Al-Harbi, Samah; Borham, Asm; Cameron, Jill I.; Cameron, Shona; Cheng, Ji; Clark, Heather; Doherty, Tim; Fayed, Nora; Gorter, Jan Willem; Herridge, Margaret S.; Khetani, Mary; Menon, Kusum; Seabrook, Jamie A.; Simpson, Racquel; Thabane, Lehana

doi:10.1097/pcc.0000000000001421

Cited by 103 publications

(108 citation statements)

References 34 publications

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“…Caregiver stress was associated with higher levels of dissatisfaction with their child's home participation. This is consistent with prior literature that found caregiver stress is associated with other poor outcomes for children, such as hospital length of stay for the PICU population and for poor recovery in other populations [4,22,39]. It is also possible the stress itself makes it difficult for caregivers to be satisfied with their child's current participation levels, or that their stress is a result of their child's participation not meeting their expectations.…”

Section: Discussionsupporting

confidence: 90%

“…This was a secondary analysis of data from Wee-Cover study, a bi-center, Canadian prospective cohort study of PICU survivors [4]. Children aged 1-17 years, admitted for at least 48 h to the PICU with organ dysfunction were enrolled.…”

Section: Populationmentioning

confidence: 99%

“…These acquired impairments in physical, cognitive, social, and emotional function following critical illness are collectively referred to as post-intensive care syndrome [2]. Recovery from post-intensive care syndrome is a complex, multi-faceted process, requiring personalized support by rehabilitation services [3,4]. If not addressed, these impairments may have persistent, long-term consequences on children's performance of daily tasks and their ability to participate in valued activities that comprise functioning and quality-of-life.…”

Section: Introductionmentioning

confidence: 99%

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Caregiver dissatisfaction with their child’s participation in home activities after pediatric critical illness

et al. 2020

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Background Pediatric critical care is often accompanied by a variety of functional impairments. Preliminary evidence suggests children’s participation in home activities has a slow trajectory post-pediatric intensive care unit (PICU) discharge, however, additional and more granular knowledge on specific problematic activities is needed to inform patient-centric rehabilitative care. The objectives of this study are to identify common home activities in which caregivers’ report dissatisfaction and to determine predictors of caregivers’ dissatisfaction with their child’s participation in home activities post-PICU discharge. Methods Secondary analyses of data from a prospective cohort study, the Wee-Cover study, using a subsample of caregivers (N = 170) of children 1–17 years, admitted to a PICU ≥48 h with data on our primary outcome measure from at least one time point. Data were gathered at enrollment and at 3 and 6 months post-PICU discharge. Caregivers reported on their dissatisfaction with their child’s participation in home activities via the Participation and Environment Measure. Common activities were identified by plotting caregiver dissatisfaction for each activity pre-and post-PICU, reporting activities in which ≥50% of caregivers reported dissatisfaction with post-PICU, and assessing for significantly different dissatisfaction levels between time-points for each activity. Predictors of caregiver dissatisfaction were assessed using Poisson generalized estimated equation models. Results There was variability in reported dissatisfaction across all activities; ≥50% of caregivers reported dissatisfaction with five activities, including getting clean, personal care management, and mealtime for younger children and household chores and homework for school-aged children and youth. Four activities had significantly higher caregiver dissatisfaction post-PICU: sleep (children < 5 years), homework, indoor play and games, and computer/video games (children ≥5 years). Home environmental support and the interaction of having participation-focused strategies with receiving PICU-based rehabilitation services were negatively associated with caregiver dissatisfaction. Increased caregiver stress and functional performance were associated with increased dissatisfaction. Conclusions Individualized PICU-based rehabilitation services to determine family priorities and develop participation-focused strategies, specifically those increasing environmental supports within the home, may ease the family’s transition home post-PICU. Trial registration ClinicalTrials.gov Identifier NCT02148081 05/28/2014.

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Section: Discussionsupporting

confidence: 90%

Section: Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Caregiver dissatisfaction with their child’s participation in home activities after pediatric critical illness

et al. 2020

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“…15 However, in recent years, both the number of critically ill patients and that of patients requiring readmission to intensive care units (ICUs) has increased. [16][17][18][19] These additional demands on limited intensive care resources have encouraged the application of noninvasive respiratory support methods in non-ICU settings including paediatric wards, emergency rooms (ERs) and during transport. Moreover, the implementation of high-dependency or step-down units with the necessary resources to safely deliver and monitor respiratory support has also assisted in reducing the need for ICU admission.…”

Section: Application Outside Of Paediatric Intensive Carementioning

confidence: 99%

Use of Noninvasive Ventilation and High-Flow Nasal Cannulae Therapy for Infants and Children with Acute Respiratory Distress Outside of Paediatric Intensive Care: A review article

Al-Mukhaini

Al-Rahbi

2020

Sultan Qaboos Univ Med J

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Noninvasive ventilation (NIV) and high-flow nasal cannulae therapy (HFNCT) are first-line methods of treatment for children presenting with acute respiratory distress, with paediatric intensive care units (PICUs) providing an ideal environment for subsequent treatment monitoring. However, the availability of step-down units, where NIV and HFNCT can be safely utilised, has reduced the need for such patients to be admitted to PICUs, thereby leading to the better overall utilisation of critical care resources. In addition, NIV and HFNCT can also be used during transport instead of invasive ventilation, thus avoiding the complications associated with the latter approach. This review article examines the safety and applicability of these respiratory support approaches outside of paediatric intensive care as well as various factors associated with treatment success or failure.Keywords: Critical Care; Children; Pediatric Intensive Care Units; Noninvasive Ventilation; Nasal Cannulae; Transportation of Patients.

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“…Both short and long hospitalizations can lead to a dramatic change in the functioning of the child and his or her parents. 7,8 Often, new diagnoses emerge and the extent of recovery may be unknown.…”

mentioning

confidence: 99%

Optimizing Discharge from Intensive Care and Follow-Up Strategies for Pediatric Patients

Andrews

Pinto

2019

The Journal of Pediatrics

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Functional Recovery in Critically Ill Children, the “WeeCover” Multicenter Study

Cited by 103 publications

References 34 publications

Caregiver dissatisfaction with their child’s participation in home activities after pediatric critical illness

Caregiver dissatisfaction with their child’s participation in home activities after pediatric critical illness

Use of Noninvasive Ventilation and High-Flow Nasal Cannulae Therapy for Infants and Children with Acute Respiratory Distress Outside of Paediatric Intensive Care: A review article

Optimizing Discharge from Intensive Care and Follow-Up Strategies for Pediatric Patients

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