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Neurologic Outcomes Following Care in the Pediatric Intensive Care Unit
Sherrill D Caprarola1, Sapna R Kudchadkar2, Melania M Bembea2
1Department of Pediatrics, Division of Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St, Houston, TX, United States, 77030.
Insights
Neurodevelopmental outcomes are increasingly important for children in the pediatric intensive care unit (PICU). Research now focuses on identifying risk factors and multidimensional neurodevelopmental assessments for better outcomes.
Area of Science:
- Pediatric Critical Care Medicine
- Neurodevelopmental Pediatrics
Background:
- Increasing survival rates in pediatric intensive care units (PICUs) highlight the importance of neurodevelopmental outcomes.
- Assessing neurological function in children post-PICU admission is a growing area of research.
Purpose of the Study:
- To systematically review recent literature on the neurologic outcomes of pediatric intensive care unit (PICU) patients.
- To understand the current focus of research regarding neurodevelopmental trajectories in this population.
Main Methods:
- Systematic review of recently published scientific literature.
- Analysis of studies focusing on neurodevelopmental and neurological outcomes in pediatric intensive care unit survivors.
Main Results:
- 3%-20% of children experience a decline in neurofunctional status after PICU admission.
- Worse outcomes are associated with primary neurologic diagnoses, cardiac arrest, and invasive interventions.
- Current research emphasizes early identification of modifiable risk factors and comprehensive, long-term neurodevelopmental assessments.
Conclusions:
- The field of pediatric critical care has evolved to prioritize survival with favorable neurologic outcomes.
- There is a shift towards multidimensional neurodevelopmental assessments beyond global cognitive function.
Purpose Of Review:
With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients.
Recent Findings:
Decline in neurofunctional status occurs in 3%-20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes. Recent research focuses on early identification and treatment of modifiable risk factors for unfavorable outcomes, and on long-term follow-up that moves beyond global cognitive outcomes and is increasingly including tests assessing multidimensional aspects of neurodevelopment.
Summary:
The pediatric critical care research community has shifted focus from survival to survival with favorable neurologic outcomes of children admitted to the PICU.
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