Quadir Ashfaque, Festa Marino, Gilchrist Michelle, Thompson Kate, Pride Natalie, Basu Shreerupa
Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney, NSW, Australia.
The University of Sydney, Sydney, NSW, Australia.
Front Pediatr. 2024 Jul 1;12:1430581. doi: 10.3389/fped.2024.1430581. eCollection 2024.
Pediatric intensive care is a rapidly developing medical specialty and with evolving understanding of pediatric pathophysiology and advances in technology, most children in the developed world are now surviving to intensive care and hospital discharge. As mortality rates for children with critical illness continue to improve, increasing PICU survivorship is resulting in significant long-term consequences of intensive care in these vulnerable patients. Although impairments in physical, psychosocial and cognitive function are well documented in the literature and the importance of establishing follow-up programs is acknowledged, no standardized or evidence-based approach to long-term follow-up in the PICU exists. This narrative review explores pediatric post-intensive care syndrome and summarizes the multifactorial deficits and morbidity that can occur in these patients following recovery from critical illness and subsequent discharge from hospital. Current practices around long-term follow-up are explored with discussion focusing on gaps in research and understanding with suggested ways forward and future directions.
儿科重症监护是一个快速发展的医学专业,随着对儿科病理生理学认识的不断深入和技术的进步,发达国家的大多数儿童现在都能在重症监护下存活并出院。随着危重病患儿死亡率的持续下降,儿科重症监护病房(PICU)幸存者数量的增加导致这些脆弱患者在重症监护后出现了重大的长期后果。尽管文献中充分记录了身体、心理社会和认知功能的损害,并且建立随访计划的重要性也得到了认可,但目前尚无针对PICU长期随访的标准化或循证方法。本叙述性综述探讨了儿科重症监护后综合征,并总结了这些患者在从危重病中康复并随后出院后可能出现的多因素缺陷和发病率。我们探讨了当前的长期随访实践,讨论的重点是研究和认识方面的差距,并提出了前进的方向和未来的发展方向。