12300The Renaissance School of Medicine at Stony Brook University and the Stony Brook Children's Hospital, Stony Brook, USA.
65830University of Minnesota Masonic Children's Hospital, Minneapolis, USA.
J Intensive Care Med. 2023 Apr;38(4):358-367. doi: 10.1177/08850666221121567. Epub 2022 Sep 7.
To map the literature regarding assessment of neurocognitive outcomes in PICU survivors. Secondary objectives were to identify literature gaps and to provide data for development of a Core Outcome Measures Set in the domain.
Planned, analysis was performed of data from an over-all scoping review of Post-Intensive Care Syndrome-pediatrics (PICS-p) functional outcomes. English-language databases and registries from 1970 to 2017 were searched by a medical librarian to identify manuscripts reporting on Post Intensive Care Syndrome-pediatrics (PICS-p). Further, detailed data extraction for neurocognitive outcomes was performed focusing on study characteristics, instruments used, and populations.
114 instruments evaluated neurocognitive function in 183 manuscripts. 83% of manuscripts were published after 2000. Median of 3 (IQR 2-5) neurocognitive instruments per manuscript were reported. Wechsler Scales (45%), clinical neurologic evaluations (21%), Pediatric Cerebral Performance Category (20%), Bayley Scales of Infant Development (16%), and Vineland Adaptive Behavior Scales (11%) were the most commonly used instruments. Median sample size was 65 (IQR 32-129) subjects. Most (63%) assessments were conducted in-person and parents/guardians (40%) provided the information. Patients with congenital heart disease and traumatic brain injury were most commonly evaluated (31% and 24% of manuscripts, respectively). Adolescents were the most commonly studied age group (34%). Baseline function was infrequently assessed (11% of manuscripts); most studies assessed patients at only one time point after PICU discharge. Within studies, neurocognitive assessments were often combined with others - especially social (18%) and physical (8%).
183 manuscripts studied the neurocognitive domain of PICS-p. Studies were quantitative and tended to focus on populations with anticipated cognitive impairment. Considerable variability exists among the chosen 114 instruments used; however, 4 instruments were frequently chosen with focus on intelligence, cerebral functioning, and developmental and adaptive behavior. The literature is marked by lack of agreement on methodologies but reflects the burgeoning interest in studying PICS-p neurocognitive outcomes.
绘制有关 PICU 幸存者神经认知结果评估的文献图谱。次要目标是确定文献差距，并为该领域的核心结局测量集提供数据。
对重症监护后综合征儿科（PICS-p）功能结局的全面范围综述数据进行计划分析。一名医学图书管理员对 1970 年至 2017 年的英语数据库和注册处进行了搜索，以确定报告儿科重症监护后综合征（PICS-p）的手稿。此外，还针对神经认知结果进行了详细的数据提取，重点关注研究特征、使用的工具和人群。
183 篇手稿中 114 种工具评估了神经认知功能。83%的手稿发表于 2000 年后。每份手稿报告中位数为 3（IQR 2-5）神经认知工具。韦氏量表（45%）、临床神经病学评估（21%）、小儿脑性能类别（20%）、贝利婴幼儿发育量表（16%）和文兰适应行为量表（11%）是最常用的工具。中位数样本量为 65（IQR 32-129）名受试者。大多数（63%）评估是亲自进行的，40%的信息来自父母/监护人。最常评估的是先天性心脏病和创伤性脑损伤患者（分别占手稿的 31%和 24%）。青少年是最常研究的年龄组（34%）。很少评估基线功能（11%的手稿）；大多数研究仅在 PICU 出院后一个时间点评估患者。在研究内，神经认知评估经常与其他评估相结合，尤其是社会评估（18%）和身体评估（8%）。
183 篇手稿研究了 PICS-p 的神经认知领域。这些研究是定量的，往往侧重于预期认知障碍的人群。选择的 114 种工具中存在相当大的差异；然而，经常选择 4 种工具，重点是智力、大脑功能以及发育和适应行为。文献缺乏方法上的一致性，但反映了人们对研究 PICS-p 神经认知结果的浓厚兴趣。
