Surviving pediatric intensive care: physical outcome after 3 months.

Abstract

This study investigated the prevalence and nature of physical and neurocognitive sequelae in pediatric intensive care unit (PICU) survivors. Prospective follow-up study 3 months after discharge from a 14-bed tertiary PICU in The Netherlands. The families of 250 previously healthy children unexpectedly admitted to the PICU were invited to visit the outpatient follow-up clinic for structured medical examination of the child 3 months after discharge; 186 patients were evaluated. Pediatric Cerebral Performance Category (PCPC) and Pediatric Overall Performance Category (POPC) values were determined at PICU discharge, at the outpatient follow-up clinic, and retrospectively before admission to the PICU. We found that 69% of children had physical sequelae. In 30% of cases these were caused by a previously unknown illness and in 39% by acquired morbidity. In 8% of the children the acquired morbidity was related to complications from PICU procedures. Three months after discharge 77% of the children had normal PCPC scores and 31% had normal POPC scores. Our results indicate that PICU survival may be associated with substantial physical sequelae. Structured follow-up research, preferably by multicenter studies, is warranted in PICU survivors.