Learning from aftercare to improve acute care

Walsh, Timothy; Endacott, Ruth

doi:10.1007/s00134-019-05657-3

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Much work has been done in the adult literature to intervene on postintensive care syndrome primarily via multidisciplinary survivorship clinics. However, significant implementation barriers exist, and efficacy data are mixed (7–10). The comparatively little research on PICS-P interventions has generally focused on specialized subsets of PICU patients, potentially missing the general PICU population who also have exposure to PICS-P risk factors (11–13).…”

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confidence: 99%

Virtual Developmental Screening After Invasive Mechanical Ventilation in Children: A Prospective Cohort Pilot Study

Bartel

Boyle

Tomlin

et al. 2022

Pediatric Critical Care Medicine

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With decreasing PICU mortality, survivor morbidity has increased. This study aims to evaluate feasibility of virtual PICU-led follow-up of patients at risk for pediatric postintensive care syndrome. DESIGN: Prospective cohort study.SETTING: Single-center, quaternary children's hospital. PATIENTS:Children less than or equal to 4 years without known preexisting neurodevelopmental deficits requiring greater than or equal to 12 hours mechanical ventilation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Age-appropriate Ages and StagesQuestionnaires, Third Edition (ASQ-3) were administered via a web-based system at 3, 6, and 12 months following PICU discharge. Primary-care physicians were notified of results; at-risk patients were referred to early developmental intervention. Forty-eight patients enrolled with median age 11.5 months (interquartile range [IQR], 2-19.5 mo) and median mechanical ventilation duration 92.5 hours (IQR, 40.5-147 hr). Fifty-eight percent completed greater than or equal to 1 ASQ-3. Lower caregiver educational achievement, lower income, and single-caregiver status were associated with lower ASQ-3 completion rates. Of those completing any ASQ-3, 50% flagged as at-risk for developmental delay and referred to early developmental intervention. There was no association between patient characteristics and abnormal ASQ-3. CONCLUSIONS:Virtual caregiver-completed surveillance is a promising method to screen children for neurodevelopmental abnormalities following PICU hospitalization and facilitate early referral for developmental intervention, but special attention must be dedicated to families with limited resources for follow-up.

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confidence: 99%