In the last decades, mortality in pediatric critical illness in the Western world has decreased to less than 5%, which resulted in increased morbidity. Therefore, the focus on outcomes has shifted from mortality to morbidities after PICU discharge. In adult critical care, these new or worsening morbidities in different domains are well described as post-intensive care syndrome (PICS), which may persist many years after ICU admission [1]. Critically ill children may also experience impairments in different domains in the short-term, e.g., physical, cognitive, emotional, and social health (◘ Fig. 62.1) [2]. Some of these impairments may remain in the long-term. Both the child’s preexisting health status and the management of acute pediatric illness might contribute to these impairments. The subjective evaluation of these impairments and their impact on daily life may result in a lower quality of life (QoL). Not only the child but also family members such as caregivers and siblings might be affected by the PICU admission and by experiencing morbidities during the period after PICU discharge.

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Outcomes in PICU

  • Karolijn Dulfer,
  • Maayke Hunfeld,
  • Lotte Haverman,
  • Corinne Buysse

摘要

In the last decades, mortality in pediatric critical illness in the Western world has decreased to less than 5%, which resulted in increased morbidity. Therefore, the focus on outcomes has shifted from mortality to morbidities after PICU discharge. In adult critical care, these new or worsening morbidities in different domains are well described as post-intensive care syndrome (PICS), which may persist many years after ICU admission [1]. Critically ill children may also experience impairments in different domains in the short-term, e.g., physical, cognitive, emotional, and social health (◘ Fig. 62.1) [2]. Some of these impairments may remain in the long-term. Both the child’s preexisting health status and the management of acute pediatric illness might contribute to these impairments. The subjective evaluation of these impairments and their impact on daily life may result in a lower quality of life (QoL). Not only the child but also family members such as caregivers and siblings might be affected by the PICU admission and by experiencing morbidities during the period after PICU discharge.