Micaëlli Delphine, Naudin Jérôme, Dauger Stéphane, Levy Michaël, Kerever Sébastien
Médecine intensive et réanimation pédiatriques, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Paris, France.
Université Paris Cité, ECEVE UMR 1123, Inserm F-75010, Paris, France.
Nurs Crit Care. 2025 May;30(3):e13187. doi: 10.1111/nicc.13187. Epub 2024 Oct 18.
Most children admitted to a paediatric intensive care unit (PICU) now survive because of improvements in care. Many studies have identified the psychological, functional, cognitive and social impact of PICU admission on a child and their family. However, expert recommendations on follow-up are lacking.
To identify the strategies of clinical follow-up after PICU discharge performed from 2001 to 2021.
This scoping review was undertaken between January and April 2021 using three databases: PubMed, EMBASE and CINAHL. The search strategy consisted of a combination of keywords, including PICU, post-PICU discharge and follow-up in articles published between 2001 and 2021. The results are reported according to PRISMA-ScR guidelines.
Six-hundred and fifty-two articles were identified and 68 were analysed. Median age was 4.5 years and the two main reasons for PICU admission were cardiorespiratory failure and sepsis. Median length of PICU stay was 8 days. Most follow-up was carried out by research units (88%), while 6% of studies reported follow-up by a multidisciplinary PICU team. The most common follow-up schedule included an assessment at PICU discharge, and then at 3, 6 and 12 months. Follow-up for >1 year was reported in 20% of studies. One third of studies focused on follow-up quality of life and neurological outcomes. Parental emotional impact was assessed in 7% of studies.
Follow-up after PICU discharge was highly heterogeneous regarding timing, health care professionals involved and assessment methods. There is an urgent need for standardization and coordination of PICU follow-up because of the increasing number of patients impacted by a PICU stay.
Although most patients admitted to a paediatric intensive care unit (PICU) now survive; they may develop paediatric post-intensive care syndrome (PICS-P). To our knowledge, there are currently no clinical guidelines regarding follow-up after PICU discharge. This review summarizes current approaches to follow-up after PICU discharge, including how it is carried out, who is involved and what the main aims of assessment are.
由于护理水平的提高，现在大多数入住儿科重症监护病房（PICU）的儿童都能存活。许多研究已经确定了入住PICU对儿童及其家庭的心理、功能、认知和社会影响。然而，缺乏关于随访的专家建议。
确定2001年至2021年期间PICU出院后进行临床随访的策略。
本范围综述于2021年1月至4月期间使用三个数据库进行：PubMed、EMBASE和CINAHL。检索策略由关键词组合而成，包括2001年至2021年发表的文章中的PICU、PICU出院后和随访。结果根据PRISMA-ScR指南报告。
共识别出652篇文章，分析了68篇。中位年龄为4.5岁，入住PICU的两个主要原因是心肺衰竭和败血症。PICU住院中位时长为8天。大多数随访由研究单位进行（88%），而6%的研究报告由多学科PICU团队进行随访。最常见的随访计划包括在PICU出院时进行评估，然后在3个月、6个月和12个月时进行评估。20%的研究报告了超过1年的随访。三分之一的研究关注随访生活质量和神经学结局。7%的研究评估了父母的情绪影响。
PICU出院后的随访在时间安排、参与的医疗保健专业人员和评估方法方面高度异质。由于受PICU住院影响的患者数量不断增加，迫切需要对PICU随访进行标准化和协调。
尽管现在大多数入住儿科重症监护病房（PICU）的患者都能存活，但他们可能会患上儿科重症监护后综合征（PICS-P）。据我们所知，目前尚无关于PICU出院后随访的临床指南。本综述总结了PICU出院后目前的随访方法，包括如何进行、涉及哪些人员以及评估的主要目的是什么。
