Knoester Hendrika, Bronner Madelon B, Bos Albert P
Pediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands.
Intensive Care Med. 2008 Jun;34(6):1076-82. doi: 10.1007/s00134-008-1061-4. Epub 2008 Mar 21.
This study investigated the prevalence and nature of physical and neurocognitive sequelae in pediatric intensive care unit (PICU) survivors.
Prospective follow-up study 3 months after discharge from a 14-bed tertiary PICU in The Netherlands.
The families of 250 previously healthy children unexpectedly admitted to the PICU were invited to visit the outpatient follow-up clinic for structured medical examination of the child 3 months after discharge; 186 patients were evaluated.
Pediatric Cerebral Performance Category (PCPC) and Pediatric Overall Performance Category (POPC) values were determined at PICU discharge, at the outpatient follow-up clinic, and retrospectively before admission to the PICU. We found that 69% of children had physical sequelae. In 30% of cases these were caused by a previously unknown illness and in 39% by acquired morbidity. In 8% of the children the acquired morbidity was related to complications from PICU procedures. Three months after discharge 77% of the children had normal PCPC scores and 31% had normal POPC scores.
Our results indicate that PICU survival may be associated with substantial physical sequelae. Structured follow-up research, preferably by multicenter studies, is warranted in PICU survivors.
本研究调查了儿科重症监护病房（PICU）幸存者身体和神经认知后遗症的患病率及性质。
在荷兰一家拥有14张床位的三级PICU出院3个月后进行的前瞻性随访研究。
邀请250名先前健康但意外入住PICU的儿童的家属，在出院3个月后带孩子到门诊随访诊所进行结构化医学检查；对186名患者进行了评估。
在PICU出院时、门诊随访诊所以及回顾性地在入住PICU之前确定儿科脑功能分类（PCPC）和儿科总体功能分类（POPC）值。我们发现69%的儿童有身体后遗症。在30%的病例中，这些后遗症由先前未知的疾病引起，在39%的病例中由获得性疾病引起。在8%的儿童中，获得性疾病与PICU操作的并发症有关。出院3个月后，77%的儿童PCPC评分正常，31%的儿童POPC评分正常。
我们的结果表明，PICU存活可能与严重的身体后遗症有关。PICU幸存者有必要进行结构化的随访研究，最好通过多中心研究进行。
