Virtual Developmental Screening After Invasive Mechanical Ventilation in Children: A Prospective Cohort Pilot Study

Area of Science:

• Pediatric critical care medicine
• Neurodevelopmental outcomes
• Healthcare technology

Background:

• Decreasing mortality in pediatric intensive care units (PICUs) has led to an increase in survivor morbidity.
• Post-intensive care syndrome (PICS) presents significant challenges for long-term child development.
• Effective follow-up strategies are needed to address neurodevelopmental deficits in young children after PICU discharge.

Purpose of the Study:

• To evaluate the feasibility of a virtual PICU-led follow-up program.
• To screen at-risk children for neurodevelopmental abnormalities post-PICU.
• To facilitate early developmental intervention for identified cases.

Main Methods:

• Prospective cohort study at a single quaternary children's hospital.
• Inclusion of children aged 4 years or younger requiring mechanical ventilation.
• Web-based administration of Ages and Stages Questionnaires, Third Edition (ASQ-3) at 3, 6, and 12 months post-discharge.

Main Results:

• 48 patients enrolled; 58% completed at least one ASQ-3.
• Lower caregiver education, income, and single-caregiver status correlated with lower completion rates.
• 50% of completers flagged as at-risk for developmental delay, leading to early intervention referrals.

Conclusions:

• Virtual, caregiver-completed surveillance is a feasible method for screening neurodevelopmental issues in children post-PICU.
• This approach aids in timely referral for developmental interventions.
• Targeted support is crucial for families facing resource limitations to ensure successful follow-up.