Muristek
Long-term Neurocognitive Morbidity After a Single Episode of Respiratory Failure in Children
The fact that most children treated in the pediatric intensive care unit (PICU) survive to hospital discharge is causing a shift from mortality to long-term morbidity as the outcome of interest in pediatric critical illness. Collectively termed pediatric post–intensive care syndrome (PICS-p), the physical, emotional, social, and cognitive sequelae of critical illness can adversely affect surviving children and their families well beyond hospitalization. Chronic comorbidities, the acute critical illness, adverse effects of PICU therapies, and the child’s home environment may all influence these post-PICU outcomes. Although studies that include children with direct neurologic injury, whether acute (eg, traumatic brain injury, drowning, meningoencephalitis) or chronic (eg, extreme prematurity, genetic syndromes), may be less suitable for identifying modifiable risk factors for PICS-p, generally healthy children with acute respiratory failure treated with mechanical ventilation—with improved gas exchange at the cost of exposure to sedative and analgesic agents and other possibly injurious PICU therapies—comprise an optimal cohort to assess the association between critical care and long-term outcomes.
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