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Functional Recovery in Critically Ill Children, the "WeeCover" Multicenter Study.

Karen Choong1, Douglas Fraser2,3, Samah Al-Harbi4

  • 1Department of Pediatrics, Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|February 3, 2018
PubMed
Summary

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Most critically ill children experience functional deterioration, but many show recovery within six months. Higher baseline function and neurological injury predict deterioration, while age and baseline function influence recovery speed.

Area of Science:

  • Pediatric Critical Care Medicine
  • Rehabilitation Medicine
  • Pediatric Health Outcomes

Background:

  • Critical illness in children can lead to significant functional impairments.
  • Understanding functional outcomes and recovery trajectories is crucial for pediatric intensive care unit (PICU) survivors.

Purpose of the Study:

  • To evaluate functional outcomes in children after critical illness.
  • To identify predictors of unfavorable functional outcomes in this population.

Main Methods:

  • Prospective observational longitudinal cohort study conducted in two Canadian tertiary care PICUs.
  • Enrolled children aged 12 months to 17 years with organ dysfunction requiring PICU admission for at least 48 hours.
  • Assessed functional outcomes using the Pediatric Evaluation of Disabilities Inventory Computer Adaptive Test up to 6 months post-PICU discharge.

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Main Results:

  • 81.5% of enrolled children experienced functional deterioration following critical illness.
  • Higher baseline function and neurological insult at PICU admission predicted functional deterioration.
  • 67.1% showed some functional recovery by 6 months; higher baseline function and increasing age were associated with slower recovery.
  • Preexisting comorbidities and PICU-acquired morbidities predicted persistent caregiver support needs.

Conclusions:

  • Critically ill children frequently experience functional deterioration, with varying recovery patterns.
  • Identifying predictors of poor outcomes can guide targeted interventions and rehabilitation strategies.
  • This study highlights the need for comprehensive follow-up care to improve long-term functional status in pediatric PICU survivors.