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Recollection of children following intensive care
S Playfor1, D Thomas, I Choonara
1Paediatric Critical Care Unit, The Hospital for Sick Children, 555 University Avenue, Toronto M5G 1X8, Canada. playfor@sickkids.on.ca
Insights
Children’s memories of the paediatric intensive care unit (PICU) are mostly neutral or positive. Sedation and mechanical ventilation impact recall of endotracheal intubation, with many patients remembering little.
Area of Science:
- Pediatric critical care medicine
- Child psychology
- Patient experience research
Background:
- The subjective experiences and memories of critically ill children after discharge from the pediatric intensive care unit (PICU) remain largely undocumented.
- Understanding these recollections is crucial for improving patient care and psychological support post-PICU.
Purpose of the Study:
- To investigate and describe the nature of children's recollections following their stay in a pediatric intensive care unit (PICU).
- To identify common themes and factors influencing memory recall in this vulnerable population.
Main Methods:
- A qualitative study involving semi-structured interviews with children aged 4 years and above after PICU discharge.
- Interviews were conducted either in-hospital or at home.
- Recollections were systematically recorded and analyzed using content analysis.
Main Results:
- A total of 38 interviews yielded 44 specific recollections.
- The majority of recollections were neutral (60%) or positive (25%), with only 15% being negative.
- Negative memories were associated with medical care aspects and environmental factors; no child recalled paralysis during neuromuscular blockade.
Conclusions:
- Children's memories of their PICU experience are predominantly neutral or positive.
- Mechanical ventilation combined with midazolam and morphine sedation significantly limits recall of endotracheal intubation.
- Findings highlight the importance of considering sedation and ventilation strategies on pediatric patient memory.
Background And Aims:
The recollections of critically ill children following discharge from the paediatric intensive care unit (PICU) have not previously been described. We have interviewed such children to establish the nature of their recollections.
Methods:
Children aged 4 years and above were interviewed following discharge from the PICU at the Queens Medical Centre, Nottingham, either in hospital or at home, using a semistructured interview. Their recollections were recorded and interpreted by content analysis.
Results:
A total of 38 interviews were carried out; 44 specific recollections were reported, the majority being neutral (60%) or positive (25%). Only 15% of recollections were negative. Negative recollections related to aspects of medical care and environmental factors. No child treated with neuromuscular blocking agents remembered any period of therapeutic paralysis.
Conclusions:
Children's recollections of PICU are mainly neutral or positive. Mechanically ventilated children sedated with midazolam and morphine remember little of endotracheal intubation.