Post-Intensive Care Syndrome In A Cohort Of School-Aged Children & Adolescents Receiving Integrated Care Via A Pediatric Critical Care & Neurotrauma Recovery Program

Abstract Objective We aimed to identify critical issues related to Post-Intensive Care Syndrome (PICS) through an integrated model of care whereby children and families participate in follow-up clinics with a neuropsychologist and a critical care physician. To demonstrate the impact of direct assessment, we present pilot program findings on early identification and treatment of PICS in a cohort of school-aged children and adolescents through a combination of multi-professional direct assessment and parent proxy questionnaires. Method 64 children and adolescents ages 8–17 years participated in the current study. PICS issues related to physical, cognitive, and psychosocial health were screened 1–3 months after discharge from the pediatric intensive care unit (PICU). The primary outcome was nine performance-based neurocognitive measures combined through principal components analysis to create a neurocognitive index (NCI). Pearson correlation (r) was used to determine the NCI association with other PICS measures at the p < 0.05 significance level. Results The NCI accounted for 52% of the overall variance. Better NCI performance was significantly associated with improved quality of life (r = 0.4). Poorer neurocognitive functioning was significantly associated with the presence of intracranial lesions on imaging (r = −0.28), a neurodevelopmental (r = −0.3) or neurocognitive (r = −0.29) disorder clinician diagnosis, and parent-reported sleep disturbances (r = −0.5), fatigue (r = −0.46), and global executive functioning (r = −0.42). Conclusions Performance-based measures of neurocognitive functioning were associated with core PICS features including physical, cognitive, and psychosocial functioning. Direct assessment of neurocognitive and psychosocial functioning in the initial healing phase following PICU admission is needed to provide patients and their families with expedited and comprehensive guidance for recovery.