Promoting Functional Recovery in Critically Ill Children

Area of Science:

• Pediatric critical care medicine
• Neuroscience
• Rehabilitation medicine

Background:

• Over two-thirds of pediatric critical illness survivors experience persistent functional impairments after discharge, termed post-intensive care syndrome in pediatrics (PICS-p).
• Risk factors for PICS-p encompass child and family characteristics, invasive procedures, and social determinants of health.
• PICS-p significantly impacts long-term quality of life and functional independence in pediatric populations.

Purpose of the Study:

• To review current understanding and approaches to managing post-intensive care syndrome in pediatrics (PICS-p).
• To identify key risk factors, remediation strategies, and challenges associated with PICS-p.
• To outline future research directions for improving PICS-p outcomes.

Main Methods:

• Literature review of pediatric critical care studies focusing on PICS-p.
• Synthesis of data on risk factors, including social determinants of health.
• Analysis of current and proposed remediation strategies and screening approaches.

Main Results:

• Established risk factors for PICS-p include child/family traits, invasive procedures, and social determinants of health.
• Effective remediation strategies involve early rehabilitation, reduced sedation, caregiver psychosocial support, family-centered care, and longitudinal PICS-p screening.
• Significant challenges remain in developing feasible screening tools and coordinating multidisciplinary care.

Conclusions:

• Post-intensive care syndrome in pediatrics is a prevalent and complex condition requiring multifaceted interventions.
• Future efforts must prioritize addressing social determinants of health and rigorously evaluating treatment efficacy and equity.
• Improved screening methods and coordinated multidisciplinary care are essential for optimizing outcomes for pediatric critical illness survivors.