Abstract
Objectives: Characterize current practices for PICU-based rehabilitation, and physician perceptions and attitudes, barriers, resources, and outcome assessment in contemporary PICU settings. Design: International, self-administered, quantitative, cross-sectional survey. Setting: Online survey distributed from March 2017 to April 2017. Patients or Subjects: Pediatric critical care physicians who subscribed to email distribution lists of the Pediatric Acute Lung Injury and Sepsis Investigators, the Pediatric Neurocritical Care Research Group, or the Prevalence of Acute Critical Neurological Disease in Children: A Global Epidemiological Assessment study group, and visitors to the World Federation of Pediatric Intensive and Critical Care Societies website. Interventions: None. Measurements and Main Results: Of the 170 subjects who began the survey, 148 completed it. Of those who completed the optional respondent information, most reported working in an academic medical setting and were located in the United States. The main findings were 1) a large majority of PICU physicians reported working in institutions with no guidelines for PICU-based rehabilitation, but expressed interest in developing and implementing such guidelines; 2) despite this lack of guidelines, an overwhelming majority of respondents reported that their current practices would involve consultation of multiple rehabilitation services for each case example provided; 3) PICU physicians believed that additional research evidence is needed to determine efficacy and optimal implementation of PICU-based rehabilitation; 4) PICU physicians reported significant barriers to implementation of PICU-based rehabilitation across centers; and 5) low routine assessment of long-term functional outcomes of PICU patients, although some centers have developed multidisciplinary follow-up programs. Conclusions: Physicians lack PICU-based rehabilitation guidelines despite great interest and current practices involving a high degree of PICU-based rehabilitation consultation. Data are needed to identify best practices and necessary resources in the delivery of ICU-based multidisciplinary rehabilitation and long-term functional outcomes assessment to optimize recovery of children and families affected by critical illness.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e274-e282 |
| Journal | Pediatric Critical Care Medicine |
| Volume | 20 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2019 |
Funding
Drs. Beers’s, Houtrow’s, Ortiz-Aguayo’s, Chrisman’s, Orringer’s, Smith’s, and Fink’s institutions received funding from Patient-Centered Outcomes Research Institute. Dr. Choong’s institution received funding from Alternate Funding Plan Innovation Grant, and she received funding from McMaster University. Dr. Kochanek receives a stipend from the Society of Critical Care Medicine and World Federation of Pediatric and Intensive Care Societies for his role as editor-in-chief of Pediatric Critical Care Medicine. Dr. Fink’s institution received funding from the National Institutes of Health. The remaining authors have disclosed that they do not have any potential conflicts of interest. This project is registered with clinicaltrials.gov (NCT02209935). For information regarding this article, E-mail: [email protected] Supported, in part, by the Patient-Centered Outcomes Research Institute (PCORI) (CER-1310–08343) (to Dr. Fink). Research reported in this article was funded through a PCORI Award (CER-1310–08343); 5T32HD040686-18 (to Dr. Treble-Barna).
Keywords
- critical care
- family-centered
- outcome
- pediatric
- rehabilitation
- survey
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Critical Care and Intensive Care Medicine