Transitions from short to long-term outcomes in pediatric critical care: considerations for clinical practice

Area of Science:

• Pediatric critical care medicine
• Developmental pediatrics
• Health outcomes research

Background:

• Increasing survival rates in pediatric intensive care units (PICUs) highlight the need to address long-term health consequences.
• Post-intensive care syndrome-pediatrics (PICS-p) affects children's development for years after critical illness.
• Current clinical practice lacks standardized follow-up recommendations for critically ill children, unlike other pediatric populations.

Purpose of the Study:

• To review considerations for implementing long-term clinical follow-up after pediatric critical illness.
• To emphasize the importance of assessing post-hospital outcomes for children surviving critical illness.
• To advocate for long-term outcomes as a new standard of care in PICUs.

Main Methods:

• This review synthesizes current research and clinical perspectives on pediatric post-intensive care outcomes.
• It examines barriers and facilitators to implementing long-term follow-up assessments.
• It discusses the growing recognition of long-term outcomes by research programs and funders.

Main Results:

• Many children experience multi-domain health sequelae post-PICU, impacting long-term development.
• Existing research often neglects post-hospital outcomes, focusing primarily on in-hospital assessments.
• Some PICU centers are successfully overcoming barriers to provide essential follow-up services.

Conclusions:

• Long-term clinical follow-up is essential for optimizing patient and family outcomes after pediatric critical illness.
• Establishing a multicenter, multinational collaborative is proposed to assess outcomes and improve care delivery.
• Integrating long-term outcome assessment into routine PICU care and research is a critical next step.