Post-Intensive Care Syndrome in Children: A Concept Analysis

Area of Science:

• Pediatric critical care medicine
• Child health outcomes
• Syndrome conceptualization

Background:

• Post-intensive care syndrome in paediatrics (PICS-p) describes impairments after pediatric intensive care unit (PICU) discharge.
• Lack of consensus and assessment guidance for PICS-p hinders understanding and management.
• This study addresses the need for a clear conceptual definition of PICS-p.

Purpose of the Study:

• To define the concept of PICS-p using the Walker and Avant concept analysis approach.
• To provide a detailed understanding of PICS-p for practitioners and researchers.
• To establish a theoretical basis for PICS-p diagnosis and treatment.

Main Methods:

• Systematic literature review across multiple databases (PubMed, Google Scholar, Web of Science, etc.).
• Keywords included 'post-intensive care syndrome', 'PICU', 'children', and 'PICS-p'.
• Included both quantitative and qualitative studies published up to November 21, 2020; 24 publications met criteria from 762 initial articles.

Main Results:

• PICS-p is characterized by four core aspects: physical dysfunction, cognitive dysfunction, psychological dysfunction, and social dysfunction.
• These dysfunctions represent newly acquired or worsened impairments in children post-PICU.
• The analysis provides a structured definition based on these identified domains.

Conclusions:

• Reduced case fatality is not the sole measure of pediatric critical care success; long-term outcomes are increasingly important.
• A clear definition of PICS-p is crucial for medical staff to understand and manage the syndrome effectively.
• This conceptualization offers a foundation for improved diagnosis, treatment, and support for children affected by PICS-p.