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Persistence of Neuropsychological Deficits Following Pediatric Critical Illness
Lorraine C Als1, Anna Tennant, Simon Nadel
11Centre for Mental Health, Department of Medicine, Imperial College London, London, United Kingdom. 2Department of Paediatric Intensive Care, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 3Department of Paediatric Intensive Care, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
Insights
Pediatric Intensive Care Unit (PICU) survivors often experience persistent neuropsychological deficits, including reduced intelligence and attention, impacting their educational progress long after discharge.
Area of Science:
- Pediatric critical care medicine
- Neuropsychology
- Child neurology
Background:
- Pediatric Intensive Care Unit (PICU) survivors face potential long-term cognitive sequelae.
- Understanding the persistence of these deficits is crucial for effective rehabilitation and support.
Purpose of the Study:
- To investigate the 12-month persistence of neuropsychological deficits in children following PICU admission.
- To assess changes in cognitive function and educational outcomes over one year.
Main Methods:
- Prospective follow-up study conducted in two PICUs.
- Participants included children aged 5-16 years with identified neuropsychological deficits 3-6 months post-PICU.
- Neuropsychological function was evaluated using standardized tests (CANTAB, CMS, WISC/WRIT).
Main Results:
- 53% of PICU-admitted children showed neuropsychological impairment 3-6 months post-discharge.
- At 12-month follow-up, memory function improved, but intelligence quotient and visual attention showed little change.
- Educational progress remained significantly below expected levels for these children.
Conclusions:
- Children surviving critical illnesses in the PICU exhibit persistent neuropsychological impairments.
- These deficits, particularly in intelligence and attention, continue to affect educational attainment one year after discharge.
Objective:
To study 12-month persistence of neuropsychological deficits in PICU survivors.
Design:
Prospective follow-up study.
Setting:
Two PICUs.
Participants:
Children 5-16 years old with neuropsychological deficits 3-6 months following PICU care for meningoencephalitis, sepsis, and other critical illnesses (excluding other primary neurological disorders).
Interventions:
None.
Measurements And Main Results:
Neuropsychological function was assessed using the Cambridge Neuropsychological Test Automated Battery, the Children's Memory Scale, and the Wechsler Abbreviated Scale of Intelligence or Wide Range Intelligence Test. Forty-seven of 88 PICU admitted children (53%) were identified as neuropsychologically impaired 3-6 months after discharge; of these, 23 provided 12-month follow-up data. In spite of significant improvements in measures of memory, there was little change in intelligence quotient and visual attention over the study period, and children's educational progress remained below expectation.
Conclusions:
We found persistently reduced neuropsychological function following PICU admission in the critical illnesses under study.
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