More than 10,000 children are hospitalized in an PICU every year in Canada. While most of them will survive their PICU hospitalization and their critical illness, some children will not recover to their pre-illness level. Some may develop behavioral, physical, emotional or developmental problems and difficulties at school. All these problems are elements that are part of the Pediatric Post-Intensive Care Syndrome (PICS-p). It is important to understand the elements (risk factors) that play a role in the development of PICS-p. In Canada, there is no systematic follow-up for children after they leave the PICU. Understanding what can cause PICS-p (risk factors) and how much PICS-p has an impact on children and their family is very important to the family well-being.
The Pediatric Post-Intensive Care Syndrome (PICS-p) is a newly developed conceptual framework that incorporates the constellation of morbidities that are increasingly recognized to affect children and their families after a critical illness. Experts define PICS-p as a new or worsening impairment in any of the following 5 domains of child health: physical, cognitive, emotional, social, or family. In contrast to well established follow-up programs in adults, there is currently a lack of systematic follow-up of PICU survivors which prevents both the recognition and management of PICS-p. The absence of granular, empirical data on the recovery of PICU children impedes both the identification and management of PICS-p. This project is a prospective Canadian multicenter cohort study to identify risk factors of PICS-p, develop and validate a predictive model for PICS-p to detect at-risk children, characterize each domain of PICS-p over two years post critical illness and uncover additional morbidities that are not captured using the current PICS-p framework. This study will provide granular, empirical data on which to build developmentally appropriate and tailored screening, management, and intervention programs during and after PICU to improve the global recovery of critically ill children and their family.
Study Type
OBSERVATIONAL
Enrollment
690
Cohort study: all parents and participants will have questionnaires to complete, based on participant's age.
Alberta Children's Hospital
Calgary, Alberta, Canada
BC Children Hospital
Vancouver, British Colombia, Canada
McMaster Children's Hospital
Hamilton, Ontario, Canada
Childrens Hospital of Eastern Ontario
Ottawa, Ontario, Canada
The Hospital for Sick Children
Toronto, Ontario, Canada
CHU Sainte-Justine
Montreal, Quebec, Canada
Montreal Children Hospital
Montreal, Quebec, Canada
Centre Hospitalier Universitaire de Sherbrooke
Sherbrooke, Quebec, Canada
Identify risk factors of PICS-p at 2 months post-PICU
Identification of modifiable and non-modifiable risk factors
Time frame: 2 months after PICU discharge
Develop and validate a model predictive of PICS-p 2 months post PICU
The model will allow detection at PICU discharge of children in need of post-PICU follow-up
Time frame: 2 months after PICU discharge
Describe the incidence of each of the five domains of PICS-p across the first two years post-PICU
Identify which domain gets impacted and when during the course of the follow-up
Time frame: At 2 months, 12, 18 months and 36 months post PICU discharge
Uncover additional post-PICU morbidities not detected within the framework of PICS-p.
Detection of morbidities through the medical provider interview that are not included in the current framework.
Time frame: Until 36 months post PICU discharge
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