Post-Intensive Care Syndrome Pediatrics, Longitudinal Cohort study

1 项目摘要 在过去的三十年里，儿科重症监护室（PICU）的生存率大幅提高， 使得死亡率本身不足以作为儿科危重疾病结局评估的指标。目前， 全面了解PICU发病率和PICU幸存者的康复轨迹， 他们的家庭有限。重症监护后综合征（PICS）包括新的或恶化的损伤， 身体、认知或心理健康状况，出现并可能在危重病后持续存在。的 儿童PICS（PICS-p）的特征尚不清楚。目前，我们无法识别可更改的风险 PICU预后不良的因素和/或发展系统的、及时的和有针对性的PICU或PICU后 干预措施，以改善PICU的发病率，而不首先了解儿童的恢复， 分享PICU的经验 在这里，我们提出了一个前瞻性纵向队列研究的患者经历>3天的ICU治疗 在20个美国PICU中的一个，对两年内的儿童和家庭结局进行评估。我们将比较 这些PICU患者与接受过夜（对照）PICU的对照组患者的结局 没有接受重症监护室治疗的住院患者以及来自 普通人群和慢性病人群。儿童和他们的家人将从每个PICU在当地登记， 他们的研究结果将由宾夕法尼亚大学和西雅图儿童中心集中跟进。 研究院我们的具体目标是（1）确定身体，认知，情感和社会 儿童危重症后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因素与受损的身体，认知， PICU幸存者的情绪和社会结果，以及（3）确定PICU幸存者的情绪和社会结果。 PICU幸存者的父母和兄弟姐妹的健康结果。我们的主要目标是阐明 儿科危重病在两年的时间内，以指导未来的干预研究，以优化儿童 家庭的结果。我们的总体目标是改善PICU幸存者及其家属的健康和福祉。 家庭 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