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Neuropsychological function in children following admission to paediatric intensive care: a pilot investigation

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Abstract

Objective

Little is known about neuropsychological status following acute severe paediatric illness. This pilot study explored the effects on memory function of severe acute paediatric illness and associations between memory functioning and psychiatric sequelae.

Design and setting

Case control study of children after paediatric intensive care unit (PICU) discharge and healthy volunteers.

Patients and participants

16 PICU discharged children comprised of 11 boys and 5 girls (mean age 9.44 ± 2.85 years) tested a mean of 4.8 ± 1.4 months following hospital discharge, and 16 age- and sex-matched controls.

Measurements and results

Visual-spatial memory and attention were assessed using the CANTAB battery (visual memory) and verbal memory with the Children Memory Scale; Intelligence Quotient was tested using the Wechsler Abbreviated Scale of Intelligence. Emotional and behavioural function was measured with the Strengths and Difficulties Questionnaire and Impact of Event Scales. Children admitted to PICU displayed statistically poorer performance on tests of spatial memory (spatial working memory) sustained attention (rapid visual information) and verbal memory (word pairs learning and delayed recognition). Septic illness was specifically associated with poorer pattern recognition memory on the CANTAB. There were significant correlations in the PICU group between cognitive functioning and emotional/behaviour scores.

Conclusions

Our results suggest impaired memory and attention in children following acute severe paediatric illness, a specific deficit in children with septic illness and links between memory anomalies and emotional/behavioural problems. The findings and their clinical significance require replication and clarification in a larger sample.

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Acknowledgements

The work was supported by a grant from Children of St. Mary's Intensive Care (COSMIC).

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Authors and Affiliations

  1. Academic Unit of Child and Adolescent Psychiatry, Imperial College London, St Mary’s Campus, Norfolk Place, W2 1PG, London, UK

    Sarah Elison, Dan Shears & M. Elena Garralda

  2. Dept of Pediatric Intensive Care, St Mary’s Hospital, Praed Street, W2 1NY, London, UK

    Simon Nadel

  3. Department of Psychiatry, University of Cambridge, School of Clinical Medicine, Addenbrooke’s Hospital, CB2 2QQ, Cambridge, UK

    Barbara Sahakian

Authors
  1. Sarah Elison
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  2. Dan Shears
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  3. Simon Nadel
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  4. Barbara Sahakian
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  5. M. Elena Garralda
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Corresponding author

Correspondence to Simon Nadel.

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Elison, S., Shears, D., Nadel, S. et al. Neuropsychological function in children following admission to paediatric intensive care: a pilot investigation. Intensive Care Med 34, 1289–1293 (2008). https://doi.org/10.1007/s00134-008-1093-9

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  • DOI: https://doi.org/10.1007/s00134-008-1093-9

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