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2017 ; 6
(2
): 124-134
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Characteristics of postintensive care syndrome in survivors of pediatric critical
illness: A systematic review
#MMPMID28529914
Herrup EA
; Wieczorek B
; Kudchadkar SR
World J Crit Care Med
2017[May]; 6
(2
): 124-134
PMID28529914
show ga
AIM: To synthesize the available evidence focusing on morbidities in pediatric
survivors of critical illness that fall within the defined construct of
postintensive care syndrome (PICS) in adults, including physical, neurocognitive
and psychological morbidities. METHODS: A comprehensive search was conducted in
MEDLINE, EMBASE, the Cochrane Library, PsycINFO, and CINAHL using controlled
vocabulary and key word terms to identify studies reporting characteristics of
PICS in pediatric intensive care unit (PICU) patients. Two reviewers
independently screened all titles and abstracts and performed data extraction.
From the 3176 articles identified in the search, 252 abstracts were identified
for full text review and nineteen were identified for inclusion in the review.
All studies reporting characteristics of PICS in PICU patients were included in
the final synthesis. RESULTS: Nineteen studies meeting inclusion criteria
published between 1995 and 2016 were identified and categorized into studies
reporting morbidities in each of three categories-physical, neurocognitive and
psychological. The majority of included articles reported prospective cohort
studies, and there was significant variability in the outcome measures utilized.
A synthesis of the studies indicate that morbidities encompassing PICS are
well-described in children who have survived critical illness, often resolving
over time. Risk factors for development of these morbidities include younger age,
lower socioeconomic status, increased number of invasive procedures or
interventions, type of illness, and increased benzodiazepine and narcotic
administration. CONCLUSION: PICS-related morbidities impact a significant
proportion of children discharged from PICUs. In order to further define PICS in
children, more research is needed using standardized tools to better understand
the scope and natural history of morbidities after hospital discharge. Improving
our understanding of physical, neurocognitive, and psychological morbidities
after critical illness in the pediatric population is imperative for designing
interventions to improve long-term outcomes in PICU patients.
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