Postintensive Care Syndrome in Pediatric Critical Care Survivors: Therapeutic Options to Improve Outcomes After Acquired Brain Injury

Cydni N Williams^{1

2}, Mary E Hartman³, Kristin P Guilliams^{3

4}, Rejean M Guerriero⁴, Juan A Piantino^{5

6}, Christopher C Bosworth⁷, Skyler S Leonard⁸, Kathryn Bradbury⁸, Amanda Wagner⁸, Trevor A Hall^{5

8}

Affiliations

¹ Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health and Science University, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA. willicyd@ohsu.edu.
² Department of Pediatrics, Division of Pediatric Critical Care, Oregon Health and Science University, Portland, OR, USA. willicyd@ohsu.edu.
³ Department of Pediatrics, Division of Critical Care Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
⁴ Department of Neurology, Division of Pediatric and Developmental Neurology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
⁵ Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health and Science University, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA.
⁶ Department of Pediatrics, Division of Pediatric Neurology, Oregon Health and Science University, Portland, OR, USA.
⁷ Department of Psychology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
⁸ Department of Pediatrics, Division of Pediatric Psychology, Oregon Health and Science University, Portland, OR, USA.

PMID: 31559490
PMCID: PMC7244217
DOI: 10.1007/s11940-019-0586-x

Review

Postintensive Care Syndrome in Pediatric Critical Care Survivors: Therapeutic Options to Improve Outcomes After Acquired Brain Injury

Cydni N Williams et al. Curr Treat Options Neurol. 2019.

. 2019 Sep 27;21(10):49.

doi: 10.1007/s11940-019-0586-x.

Authors

Affiliations

¹ Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health and Science University, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA. willicyd@ohsu.edu.
² Department of Pediatrics, Division of Pediatric Critical Care, Oregon Health and Science University, Portland, OR, USA. willicyd@ohsu.edu.
³ Department of Pediatrics, Division of Critical Care Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
⁴ Department of Neurology, Division of Pediatric and Developmental Neurology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
⁵ Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health and Science University, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA.
⁶ Department of Pediatrics, Division of Pediatric Neurology, Oregon Health and Science University, Portland, OR, USA.
⁷ Department of Psychology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
⁸ Department of Pediatrics, Division of Pediatric Psychology, Oregon Health and Science University, Portland, OR, USA.

PMID: 31559490
PMCID: PMC7244217
DOI: 10.1007/s11940-019-0586-x

Abstract

Purpose of review: Children surviving the pediatric intensive care unit (PICU) with neurologic illness or injury have long-term morbidities in physical, cognitive, emotional, and social functioning termed postintensive care syndrome (PICS). In this article, we review acute and longitudinal management strategies available to combat PICS in children with acquired brain injury.

Recent findings: Few intervention studies in this vulnerable population target PICS morbidities. Small studies show promise for both inpatient- and outpatient-initiated therapies, mainly focusing on a single domain of PICS and evaluating heterogeneous populations. While evaluating the effects of interventions on longitudinal PICS outcomes is in its infancy, longitudinal clinical programs targeting PICS are increasing. A multidisciplinary team with inpatient and outpatient presence is necessary to deliver the holistic integrated care required to address all domains of PICS in patients and families. While PICS is increasingly recognized as a chronic problem in PICU survivors with acquired brain injury, few interventions have targeted PICS morbidities. Research is needed to improve physical, cognitive, emotional, and social outcomes in survivors and their families.

Keywords: Brain injury; Critical care; Outcomes; Pediatric; Stroke.

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Conflict of interest statement

Disclosures: The authors have no conflicts of interest or financial relationships relevant to this article to disclose

References

1. Wainwright MS, Hansen G Piantino J Pediatric neurocritical care in the 21st century: from empiricism to evidence. Curr Opin Crit Care 2016:1–7. - PubMed
1. Moreau JF, Fink EL, Hartman ME, et al. Hospitalizations of children with neurologic disorders in the United States. Pediatr Crit Care Med 2013;14(8):801–10. - PMC - PubMed
1. Williams CN, Piantino J, McEvoy C, Fino N Eriksson CO The Burden of Pediatric Neurocritical Care in the United States. Pediatr Neurol 2018;89:31–8. - PMC - PubMed
1. Choong K, Fraser D, Al-Harbi S, et al. Functional Recovery in Critically Ill Children, the “WeeCover” Multicenter Study. Pediatr Crit Care Med 2018;19(2):145–54. - PubMed
1. Williams CN, Eriksson C, Piantino J, et al. Long-term Sequelae of Pediatric Neurocritical Care: The Parent Perspective. J Pediatr Intensive Care 2018;7(4):173–81. - PMC - PubMed

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Postintensive Care Syndrome in Pediatric Critical Care Survivors: Therapeutic Options to Improve Outcomes After Acquired Brain Injury

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Postintensive Care Syndrome in Pediatric Critical Care Survivors: Therapeutic Options to Improve Outcomes After Acquired Brain Injury

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