Boeschoten Shelley A, Dulfer Karolijn, Boehmer Annemie L M, Merkus Peter J F M, van Rosmalen Joost, de Jongste Johan C, de Hoog Matthijs, Buysse Corinne M P
Intensive Care Unit, Department of Pediatrics and Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands.
Dept of Pediatrics, Maasstad Hospital, Rotterdam, the Netherlands.
Pediatr Pulmonol. 2020 Aug 20;55(11):2883-92. doi: 10.1002/ppul.25034.
To prospectively evaluate quality of life (QoL) and psychosocial outcomes in children with severe acute asthma (SAA) after pediatric intensive care (PICU) admission compared to children with SAA who were admitted to a general ward (GW). In addition, we assessed post-traumatic stress (PTS) and asthma-related QoL in the parents.
A preplanned follow-up of 3-9 months of our nationwide prospective multicenter study, in which children with SAA admitted to a Dutch PICU (n=110) or GW (n=111) were enrolled between 2016-2018. Asthma-related QoL, PTS symptoms, emotional and behavioral problems, and social impact in children and/or parents were assessed with validated web-based questionnaires.
We included 100 children after PICU and 103 after GW admission, with a response rate of 50% for the questionnaires. Median time to follow-up was 5 months (range 1-12 months). Time to reach full schooldays after admission was significantly longer in the PICU group (mean of 10 vs 4 days, p=0.001). Parents in the PICU group reported more PTS symptoms (intrusion p=0.01, avoidance p=0.01, arousal p=0.02) compared to the GW group.
No significant differences were found between PICU and GW children on self-reported outcome domains, except for the time to reach full schooldays. PICU parents reported PTS symptoms more often than the GW group. Therefore, monitoring asthma symptoms and psychosocial screening of children and parents after PICU admission should both be part of standard care after SAA. This should identify those who are at risk for developing PTSD, in order to timely provide appropriate interventions. This article is protected by copyright. All rights reserved.
前瞻性评估与入住普通病房（GW）的重症急性哮喘（SAA）患儿相比，入住儿科重症监护病房（PICU）的SAA患儿的生活质量（QoL）和心理社会结局。此外，我们评估了患儿父母的创伤后应激（PTS）和与哮喘相关的生活质量。
对我们全国性前瞻性多中心研究进行3至9个月的预先计划的随访，该研究纳入了2016年至2018年间入住荷兰PICU（n = 110）或GW（n = 111）的SAA患儿。使用经过验证的基于网络的问卷评估患儿和/或父母的哮喘相关生活质量、PTS症状、情绪和行为问题以及社会影响。
我们纳入了100名入住PICU后的患儿和103名入住GW后的患儿，问卷回复率为50%。随访的中位时间为5个月（范围1至12个月）。PICU组患儿入院后恢复全天上学的时间明显更长（平均10天对4天，p = 0.001）。与GW组相比，PICU组的父母报告了更多的PTS症状（侵入p = 0.01，回避p = 0.01，唤醒p = 0.02）。
除了恢复全天上学的时间外，在自我报告的结局领域中，PICU患儿和GW患儿之间未发现显著差异。PICU患儿的父母比GW组更常报告PTS症状。因此，监测哮喘症状以及对PICU入院后的患儿及其父母进行心理社会筛查均应成为SAA后标准护理的一部分。这应识别出有患创伤后应激障碍风险的人群，以便及时提供适当的干预措施。本文受版权保护。保留所有权利。
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