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Is it time to see beyond ICU: Paediatrics
Most children are surviving critical illness in highly resourced paediatric intensive care units (PICUs). However, in research studies, many of these children survive with multi-domain health sequelae that has the potential to affect development and be life-long, termed post-intensive care syndrome-paediatrics (PICS-p). Clinically, there are no recommendations for the assessment and follow-up of children with critical illness as exists for the premature neonatal and congenital heart disease populations.
To date, primary and secondary outcomes have been largely assessed at or prior to hospital discharge, disregarding post-hospital outcomes important to PICU stakeholders. Incorporating longer term outcomes into clinical and research programs, however, can no longer be overlooked. Barriers to outcomes assessments are varied and generalized vs. individualized, but some PICU centres are discovering how to overcome them and are providing this service to families – sometimes specific populations - in need. Research programs and funders are increasingly recognizing the value and need to assess long-term outcomes post-PICU.
The considerations, challenges and barriers to long-term follow-up following paediatric critical illness will be explored and current national and international approaches to research and clinical follow-up discussed.