Post-Intensive Care Syndrome Pediatrics, Longitudinal Cohort study

1 项目摘要 在过去的三十年里，儿科重症监护病房(PICU)的存活率大幅增加， 使死亡率本身不足以作为儿科危重疾病预后评估的指标。目前， 全面了解PICU幸存者的PICU发病率和康复轨迹 他们的家庭有限。重症监护后综合征(PICS)包括新的或不断恶化的 病情危重后出现并可能持续的身体、认知或心理健康状态。这个 儿童PICS的特点(PICS-p)尚不清楚。目前，我们无法确定可更改的风险 PICU结局差的因素和/或发展成系统的、及时的和有针对性的PICU或PICU后 在不了解儿童康复情况的情况下改善PICU发病率的干预措施通常 分享PICU的经验。 在这里，我们提出了一项对接受3天ICU治疗的患者进行前瞻性纵向队列研究。 (案例)在20个美国PICU中的一个，评估两年来儿童和家庭的结果。我们会比较一下 这些PICU患者与接受过夜(对照)PICU的对照组患者的结果 没有接受重症监护病房治疗的Stay患者，以及来自 普通人群和慢性病患者。儿童及其家庭将从每个PICU在当地招收， 宾夕法尼亚大学和西雅图儿童中心将集中关注他们的结果 研究所。我们的具体目标是(1)确定身体、认知、情感和社交 危重疾病后儿童人群的健康结果和康复轨迹；(2)确定 基线健康、存在的问题和PICU因素与身体、认知、 PICU幸存者的情绪和社会结果，以及(3)确定情感和社会结果 PICU幸存者的父母和兄弟姐妹的健康状况。我们的主要目标是阐明 为期两年的儿科危重疾病指导未来干预研究，以优化儿童 和家庭结果。我们的总体目标是改善PICU幸存者和他们的健康和福祉 家人。 1

1 Project Summary Pediatric Intensive Care Unit (PICU) survival has increased substantially over the past three decades, rendering mortality alone an insufficient metric for pediatric critical illness outcomes assessment. Currently, a comprehensive understanding of PICU morbidity and the trajectory of recovery among PICU survivors and their families is limited. Post-intensive care syndrome (PICS) consists of new or worsening impairments in physical, cognitive, or mental health status that arise and may persist after critical illness. The characteristics of PICS in children (PICS-p) are unknown. At this time, we cannot identify modifiable risk factors for poor PICU outcomes and/or develop systematic, timely, and targeted PICU or post-PICU interventions to improve PICU morbidity without first understanding the recovery in children who commonly share the PICU experience. Here, we propose a prospective longitudinal cohort study of patients undergoing >3 days of ICU therapies (case) at one of 20 US PICUs to evaluate child and family outcomes over two years. We will compare outcomes of these PICU patients with a control group of patients who received an overnight (control) PICU stay who did not receive intensive care unit therapies as well as with published quality of life data from the general and chronically ill populations. Children and their families will be enrolled locally from each PICU, and their outcomes will be followed centrally from the University of Pennsylvania and Seattle Children’s Research Institute. Our specific aims are (1) to determine the physical, cognitive, emotional, and social health outcomes and trajectory of recovery in a population of children post-critical illness; (2) to determine the baseline health, presenting problem, and PICU factors associated with impaired physical, cognitive, emotional, and social outcomes among PICU survivors, and (3) to determine the emotional and social health outcomes in parents and siblings of PICU survivors. Our primary goal is to explicate the impact of pediatric critical illness over a two-year period of time to guide future intervention research to optimize child and family outcomes. Our overall goal is to improve the health and well-being of PICU survivors and their families. 1