Yang Chun-Feng, Xue Yang, Feng Jun-Yan, Jia Fei-Yong, Zhang Yu, Li Yu-Mei
Department of Pediatrics Intensive Care Unit, The First Hospital of Jilin University, Changchun, 130021, China.
Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China.
BMC Pediatr. 2019 Dec 21;19(1):508. doi: 10.1186/s12887-019-1893-9.
Increasing studies have focused on motor function/dysfunction in PICU survivors; however, most studies have focused on adults and older children. This study investigated gross motor developmental function outcomes in infantile and toddler pediatric intensive care unit (PICU) survivors and the factors associated with gross motor developmental functions.
This observational study was conducted in the PICU of the First Hospital of Jilin University between January 2019 and March 2019. Thirty-five eligible patients were divided into the dysfunctional (n = 24) or non-dysfunctional (n = 11) group according to the results of the Peabody Developmental Motor Scales, Second Edition (PDMS-2). Baseline gross motor function for all participants before PICU admission was measured via the Age and Stages Questionnaires, Third Edition (ASQ-3). The PDMS-2 was used to evaluate gross motor development function before PICU discharge.
The gross motor developmental dysfunction incidence was 68.6%. Linear correlation analysis showed that the gross motor quotient (GMQ) was positively correlated with the pediatric critical illness score (PCIS, r = 0.621, P < 0.001), and negatively correlated with length of PICU stay (r = - 0.556, P = 0.001), days sedated (r = - 0.602, P < 0.001), days on invasive mechanical ventilation (IMV; r = - 0.686, P < 0.001), and days on continuous renal replacement therapy (CRRT; r = - 0.538, P = 0.001). Linear regression analysis showed that IMV days (β = - 0.736, P = 0.001), sepsis (β = - 18.111, P = 0.003) and PCIS (β = 0.550, P = 0.021) were independent risk factors for gross motor developmental dysfunction.
Gross motor developmental dysfunction in infantile and toddler PICU survivors is more common and may be exacerbated by experiences associated with longer IMV days and increasing illness severity combined with sepsis.
The trial 'Early rehabilitation intervention for critically ill children' has been registered at http://www.chictr.org.cn/showproj.aspx?proj=23132. Registration number: ChiCTR1800020196.
越来越多的研究聚焦于儿科重症监护病房（PICU）幸存者的运动功能/功能障碍；然而，大多数研究集中在成人和大龄儿童。本研究调查了婴幼儿PICU幸存者的粗大运动发育功能结局以及与粗大运动发育功能相关的因素。
本观察性研究于2019年1月至2019年3月在吉林大学第一医院PICU进行。根据第二版皮博迪发育运动量表（PDMS-2）的结果，35名符合条件的患者被分为功能障碍组（n = 24）或非功能障碍组（n = 11）。所有参与者在入住PICU前的基线粗大运动功能通过第三版年龄与发育阶段问卷（ASQ-3）进行测量。PDMS-2用于评估PICU出院前的粗大运动发育功能。
粗大运动发育功能障碍发生率为68.6%。线性相关分析显示，粗大运动商数（GMQ）与儿科危重病评分（PCIS，r = 0.621，P < 0.001）呈正相关，与PICU住院时间（r = -0.556，P = 0.001）、镇静天数（r = -0.602，P < 0.001）、有创机械通气（IMV）天数（r = -0.686，P < 0.001）以及持续肾脏替代治疗（CRRT）天数（r = -0.538，P = 0.001）呈负相关。线性回归分析显示，IMV天数（β = -0.736，P = 0.001）、脓毒症（β = -18.111，P = 0.003）和PCIS（β = 0.550，P = 0.021）是粗大运动发育功能障碍的独立危险因素。
婴幼儿PICU幸存者的粗大运动发育功能障碍较为常见，且可能因较长的IMV天数以及病情严重程度增加合并脓毒症等经历而加重。
“危重症儿童早期康复干预”试验已在http://www.chictr.org.cn/showproj.aspx?proj=23132注册。注册号：ChiCTR1800020196。
