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Postintensive Care Syndrome in Pediatric Critical Care Survivors: Therapeutic Options to Improve Outcomes After Acquired Brain Injury

  • Critical Care Neurology (H Hinson, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review

Children surviving the pediatric intensive care unit (PICU) with neurologic illness or injury have long-term morbidities in physical, cognitive, emotional, and social functioning termed postintensive care syndrome (PICS). In this article, we review acute and longitudinal management strategies available to combat PICS in children with acquired brain injury.

Recent findings

Few intervention studies in this vulnerable population target PICS morbidities. Small studies show promise for both inpatient- and outpatient-initiated therapies, mainly focusing on a single domain of PICS and evaluating heterogeneous populations. While evaluating the effects of interventions on longitudinal PICS outcomes is in its infancy, longitudinal clinical programs targeting PICS are increasing. A multidisciplinary team with inpatient and outpatient presence is necessary to deliver the holistic integrated care required to address all domains of PICS in patients and families.

Summary

While PICS is increasingly recognized as a chronic problem in PICU survivors with acquired brain injury, few interventions have targeted PICS morbidities. Research is needed to improve physical, cognitive, emotional, and social outcomes in survivors and their families.

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References and Recommended Reading

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Funding

Dr. Williams is supported by the Agency for Healthcare Research and Quality, grant number K12HS022981. Dr. Guilliams is supported by the National Institute of Neurologic Disorders and Stroke, grant number K23NS099472. Dr. Piantino is supported by the National Heart, Lung and Blood Institute, grant number K12HL133115.

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Authors and Affiliations

  1. Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health and Science University, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA

    Cydni N. Williams MD, Juan A. Piantino MD & Trevor A. Hall PsyD, ABPdN

  2. Department of Pediatrics, Division of Pediatric Critical Care, Oregon Health and Science University, Portland, OR, USA

    Cydni N. Williams MD

  3. Department of Pediatrics, Division of Critical Care Medicine, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, MO, USA

    Mary E. Hartman MD, MPH & Kristin P. Guilliams MD, MSCI

  4. Department of Neurology, Division of Pediatric and Developmental Neurology, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, MO, USA

    Kristin P. Guilliams MD, MSCI & Rejean M. Guerriero DO

  5. Department of Pediatrics, Division of Pediatric Neurology, Oregon Health and Science University, Portland, OR, USA

    Juan A. Piantino MD

  6. Department of Psychology, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, MO, USA

    Christopher C. Bosworth PhD

  7. Department of Pediatrics, Division of Pediatric Psychology, Oregon Health and Science University, Portland, OR, USA

    Skyler S. Leonard MEd, MA, Kathryn Bradbury PhD, Amanda Wagner PhD & Trevor A. Hall PsyD, ABPdN

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Williams, C.N., Hartman, M.E., Guilliams, K.P. et al. Postintensive Care Syndrome in Pediatric Critical Care Survivors: Therapeutic Options to Improve Outcomes After Acquired Brain Injury. Curr Treat Options Neurol 21, 49 (2019). https://doi.org/10.1007/s11940-019-0586-x

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