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Current Knowledge Regarding Long-Term Consequences of Pediatric Intensive Care: A Staff Survey in Intensive Care
Florian Von Borell1, Juliane Engel2, Felix Neunhoeffer2
1Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany.
Insights
Post Intensive Care Syndrome (PICS) is underrecognized in German pediatric ICUs. Few units implement PICS prevention or therapy, despite high rates of long-term consequences in children.
Area of Science:
- Pediatric Critical Care Medicine
- Intensive Care Unit Management
- Patient Outcomes
Background:
- Post Intensive Care Syndrome (PICS) encompasses new physical, cognitive, social, or mental health impairments following critical illness.
- While PICS prevention and therapy concepts have emerged, their adoption in German-speaking countries remains uncertain.
Purpose of the Study:
- To assess the awareness and implementation of PICS prevention and therapy strategies in German-speaking pediatric intensive care units (PICUs).
- To investigate the perceived importance and management of long-term consequences of pediatric intensive care.
Main Methods:
- An anonymous online survey was distributed to the heads of 98 PICUs in German-speaking countries.
- The survey targeted knowledge of long-term consequences and established PICS prevention/therapy measures.
Main Results:
- Only 31% of respondents considered PICS important in daily practice; an estimated 42% of children experience long-term consequences.
- Follow-up outpatient clinics were reported by only 14%, with lack of time and staff cited as barriers.
- Key outcomes focused on normal developmental trajectory (59%) and quality of life (52%).
Conclusions:
- PICS appears significantly underrepresented in German-speaking PICUs.
- There is a critical need to enhance knowledge of pediatric critical care's long-term effects and promote follow-up programs to improve patient outcomes.
Background:
The Post Intensive Care Syndrome (PICS) describes new impairments of physical, cognitive, social, or mental health after critical illness. In recent years, prevention and therapy concepts have been developed. However, it is unclear whether and to what extent these concepts are known and implemented in hospitals in German-speaking countries.
Methods:
We conducted an anonymous online survey in German-speaking pediatric intensive care units on the current state of knowledge about the long-term consequences of intensive care treatment as well as about already established prevention and therapy measures. The request to participate in the survey was sent to the heads of the PICUs of 98 hospitals.
Results:
We received 98 responses, 54% of the responses came from nurses, 43% from physicians and 3% from psychologist, all working in intensive care. As a main finding, our survey showed that for only 31% of the respondents PICS has an importance in their daily clinical practice. On average, respondents estimated that about 42% of children receiving intensive care were affected by long-term consequences after intensive care. The existence of a follow-up outpatient clinic was mentioned by 14% of the respondents. Frequent reported barriers to providing follow-up clinics were lack of time and staff. Most frequent mentioned core outcome parameters were normal developmental trajectory (59%) and good quality of life (52%).
Conclusion:
Overall, the concept of PICS seems to be underrepresented in German-speaking pediatric intensive care units. It is crucial to expand knowledge on long-term complications after pediatric critical care and to strive for further research through follow-up programs and therewith ultimately improve long-term outcomes.
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