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Multisystem Inflammatory Syndrome in Children in the Critical Care Setting
Kristin Atlas1, Jessica Strohm Farber2, Kerry Shields3
1Kristin Atlas is a clinical nurse specialist in the infant transitional care unit, Children's Hospital of Philadelphia, and a clinical instructor for the undergraduate BSN program, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
Insights
Multisystem inflammatory syndrome in children (MIS-C) is a new condition linked to COVID-19. This review covers MIS-C physiology, symptoms, diagnosis, and critical care nursing, emphasizing cardiovascular risks.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Public health
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a novel condition associated with the COVID-19 pandemic.
- Children with MIS-C present with nonspecific symptoms like fever, rash, and gastrointestinal distress, often after SARS-CoV-2 exposure.
Purpose of the Study:
- To synthesize current knowledge on MIS-C, covering its physiology, clinical presentation, diagnostic findings, and therapeutic strategies.
- To outline essential nursing considerations for managing MIS-C patients in critical care settings.
Main Methods:
- An integrative review methodology was employed.
- Literature search utilized keywords such as "multisystem inflammatory syndrome in children," "Kawasaki-like syndrome," "COVID," "COVID-19," and "SARS-CoV-2."
- Initial search yielded 324 articles; 34 were included after screening, with 8 additional articles identified through hand-searching and ongoing literature surveillance.
Main Results:
- Information regarding MIS-C diagnosis, treatment, and patient outcomes is still developing due to its recent emergence.
- Critical care nursing for MIS-C involves specific considerations, including infection control for COVID-19, comprehensive physical assessments, medication management, and precise laboratory sample timing.
- Supportive care, including anticipatory guidance for patients and families, is a crucial component of nursing management.
Conclusions:
- Critical care nurses require up-to-date information on MIS-C management.
- Patients with MIS-C frequently require intensive care due to a significant risk of cardiovascular complications.
Background:
Multisystem inflammatory syndrome in children is a new syndrome that has been hypothesized to be connected with the COVID-19 pandemic. Children are presenting-likely after SARS-CoV-2 infection or exposure-with vague symptoms including fever, gastrointestinal distress, and/or rash.
Objective:
To review what is currently known about multisystem inflammatory syndrome in children, including physiology, signs and symptoms, laboratory and imaging findings, treatment options, and nursing considerations in critical care settings.
Methods:
This integrative review was conducted using the keywords multisystem inflammatory syndrome in children, Kawasaki-like syndrome, COVID, COVID-19, and SARS-CoV-2. Initially, 324 articles were found. All were screened, and 34 were included. Eight articles were added after hand-searching and weekly literature searches were conducted.
Data Synthesis:
Multisystem inflammatory syndrome in children is a newly identified syndrome, thus information on diagnosis, treatment, and outcomes is available but evolving. Many aspects of nursing care are important to consider with regard to this illness, including COVID precautions, physical assessments, medication administration, and timing of blood sampling for laboratory testing as well as other standard intensive care unit considerations. Providing anticipatory guidance and support to patients and their families is also important.
Conclusion:
Critical care nurses must remain informed about advances in the care of patients with multisystem inflammatory syndrome in children, as these patients are often seen in critical care environments because of their high risk of cardiovascular failure.
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