Renal Disease, Liver Diseases, Heart Diseases, Trauma Injury, Sepsis, Septic Shock, Pneumonia, Bronchiolitis
Conditions
Keywords
Pediatric Intensive Care Unit, PICU
Brief summary
More than 10,000 children are hospitalized in an PICU every year in Canada. While most of them will survive their PICU hospitalization and their critical illness, some children will not recover to their pre-illness level. Some may develop behavioral, physical, emotional or developmental problems and difficulties at school. All these problems are elements that are part of the Pediatric Post-Intensive Care Syndrome (PICS-p). It is important to understand the elements (risk factors) that play a role in the development of PICS-p. In Canada, there is no systematic follow-up for children after they leave the PICU. Understanding what can cause PICS-p (risk factors) and how much PICS-p has an impact on children and their family is very important to the family well-being.
Detailed description
The Pediatric Post-Intensive Care Syndrome (PICS-p) is a newly developed conceptual framework that incorporates the constellation of morbidities that are increasingly recognized to affect children and their families after a critical illness. Experts define PICS-p as a new or worsening impairment in any of the following 5 domains of child health: physical, cognitive, emotional, social, or family. In contrast to well established follow-up programs in adults, there is currently a lack of systematic follow-up of PICU survivors which prevents both the recognition and management of PICS-p. The absence of granular, empirical data on the recovery of PICU children impedes both the identification and management of PICS-p. This project is a prospective Canadian multicenter cohort study to identify risk factors of PICS-p, develop and validate a predictive model for PICS-p to detect at-risk children, characterize each domain of PICS-p over two years post critical illness and uncover additional morbidities that are not captured using the current PICS-p framework. This study will provide granular, empirical data on which to build developmentally appropriate and tailored screening, management, and intervention programs during and after PICU to improve the global recovery of critically ill children and their family.
Interventions
OTHERneurocognitive tests
Cohort study: all parents and participants will have questionnaires to complete, based on participant's age.
Sponsors
Canadian Institutes of Health Research (CIHR)
St. Justine's Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 18 Years
Healthy volunteers
No
Inclusion criteria
* Children ≤18yo hospitalized in PICU for ≥96 hours
Exclusion criteria
1. gestational age \<37 weeks or age \>18 years at PICU entry; 2. admitted for congenital heart surgery (followed in neuro-cardiac clinics in most centers); 3. anticipated life expectancy \<1year (e.g., active do not resuscitate status).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Identify risk factors of PICS-p at 2 months post-PICU | 2 months after PICU discharge | Identification of modifiable and non-modifiable risk factors |
| Develop and validate a model predictive of PICS-p 2 months post PICU | 2 months after PICU discharge | The model will allow detection at PICU discharge of children in need of post-PICU follow-up |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Describe the incidence of each of the five domains of PICS-p across the first two years post-PICU | At 2 months, 12, 18 months and 36 months post PICU discharge | Identify which domain gets impacted and when during the course of the follow-up |
| Uncover additional post-PICU morbidities not detected within the framework of PICS-p. | Until 36 months post PICU discharge | Detection of morbidities through the medical provider interview that are not included in the current framework. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Describe families' healthcare requirements throughout their recovery process after PICU. | Until 36 months post PICU discharge | Descrie the variety of healthcare professional and medical required post PICU hospitalization. |
Countries
Canada
Contacts
Primary ContactGeneviève Du Pont-Tibodeau, MD
Backup ContactLaurence Ducharme-Crevier, MD
Outcome results
None listed