The need for PICU follow-up and evaluation of post-intensive care syndrome in pediatrics in a community children's hospital.

Abstract

Objective: Children admitted to the PICU are at risk for acquiring morbidities from their hospitalization known as post-intensive care syndrome in pediatrics (PICS-p). The objectives of this study were to examine the need for neurocognitive follow-up in evaluating for PICS-p, describe acquired PICS-p morbidities, and characterize recommended interventions. Methods: Children ages 1 day to 18 years admitted to the PICU between January 1, 2016 to December 31, 2023 who were evaluated in the pediatric neuropsychology outpatient clinic within 3-8 months of hospital discharge were included. Results: Among 453 referrals, 343 (76%) children were evaluated by the neuropsychology team. The most common post-discharge morbidities were sleep disturbances (63%), developmental/functional concerns (60%), and coping difficulties (56%). 289 children (84%) received interventions as a result of their neurocognitive evaluations. Medical interventions including referrals to physical, occupational, and speech therapy, psychiatry, psychotherapy, and neurology were recommended for 73.8% of children. Home interventions to address sleep and mood disturbances were recommended for 73.2% of children. Academic interventions including recommendations for educational services and provision of additional time to complete tasks were provided for 76.1% of children. Conclusions: The majority of children received recommendations for interventions as a result of their evaluations suggesting that neurocognitive follow-up has a role following pediatric critical illness. The high uptake of neuropsychology services among children referred for follow-up suggests that many PICU survivors experience significant functional and psychosocial morbidities after hospital discharge and are willing to seek support.