Defining Pediatric Chronic Critical Illness: A Scoping Review*-Reference-Cited by-同舟云学术

Defining Pediatric Chronic Critical Illness: A Scoping Review*

Published:2022-12-16 Issue:2 Volume:24 Page:e91-e103
ISSN:1529-7535
Container-title:Pediatric Critical Care Medicine
language:en
Short-container-title:

Author:

Zorko David J.¹²,McNally James Dayre³⁴,Rochwerg Bram⁵⁶,Pinto Neethi⁷,O’Hearn Katie⁴,Almazyad Mohammed A.⁸⁹,Ames Stefanie G.¹⁰,Brooke Peter¹¹,Cayouette Florence¹²,Chow Cristelle¹³,Junior José Colleti¹⁴,Francoeur Conall¹⁵,Heneghan Julia A.¹⁶,Kazzaz Yasser M.¹⁷,Killien Elizabeth Y.¹⁸,Jayawarden Supun Kotteduwa¹⁹,Lasso Ruben²⁰²¹,Lee Laurie A.²²²³²⁴,O’Mahony Aoife²⁵,Perry Mallory A.²⁶,Rodríguez-Rubio Miguel²⁷²⁸,Sandarage Ryan¹⁹,Smith Hazel A.²⁹,Welten Alexandra⁴³⁰,Yee Belinda¹⁹,Choong Karen²⁶³¹,

Affiliation:

1. Department of Critical Care Medicine, University of Toronto, Toronto, ON, Canada

2. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

3. Department of Pediatrics, CHEO, Ottawa, ON, Canada

4. CHEO Research Institute, Ottawa, ON, Canada

5. Division of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada

6. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

7. Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA

8. Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia

9. Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia

10. Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT

11. Paediatric Intensive Care Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom

12. Paediatric Intensive Care Unit, Great Ormond Street Hospital NHS Trust, London, United Kingdom

13. Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore

14. Department of Pediatrics, Hospital Assunção Rede D’Or, São Bernardo do Campo, São Paulo, Brazil

15. Department of Pediatrics, CHU de Québec, University of Laval Research Center, Quebec, QC, Canada

16. Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN

17. Department of Pediatrics, Ministry of the National Guard - Health Affairs, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University - Health Sciences, Riyadh, Saudi Arabia

18. Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA

19. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

20. Department of Pediatrics and Pediatric Critical Care, Fundación Valle del Lili, Cali, Colombia

21. Universidad ICESI, Cali, Colombia

22. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

23. Pediatric Intensive Care Unit, Alberta Children’s Hospital, Alberta Health Services, Calgary, AB, Canada

24. Faculty of Nursing, University of Calgary, Calgary, AB, Canada

25. School of Psychology, Cardiff University, Cardiff, United Kingdom

26. Children’s Hospital of Philadelphia Research Institute, Philadelphia, PA

27. Department of Pediatric Intensive Care, Hospital Universitario La Paz, Madrid, Spain

28. Departamento de Peditaría, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain

29. Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland

30. Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada

31. Division of Pediatric Critical Care Medicine, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.

Abstract

OBJECTIVES: Children with chronic critical illness (CCI) are hypothesized to be a high-risk patient population with persistent multiple organ dysfunction and functional morbidities resulting in recurrent or prolonged critical care; however, it is unclear how CCI should be defined. The aim of this scoping review was to evaluate the existing literature for case definitions of pediatric CCI and case definitions of prolonged PICU admission and to explore the methodologies used to derive these definitions. DATA SOURCES: Four electronic databases (Ovid Medline, Embase, CINAHL, and Web of Science) from inception to March 3, 2021. STUDY SELECTION: We included studies that provided a specific case definition for CCI or prolonged PICU admission. Crowdsourcing was used to screen citations independently and in duplicate. A machine-learning algorithm was developed and validated using 6,284 citations assessed in duplicate by trained crowd reviewers. A hybrid of crowdsourcing and machine-learning methods was used to complete the remaining citation screening. DATA EXTRACTION: We extracted details of case definitions, study demographics, participant characteristics, and outcomes assessed. DATA SYNTHESIS: Sixty-seven studies were included. Twelve studies (18%) provided a definition for CCI that included concepts of PICU length of stay (n = 12), medical complexity or chronic conditions (n = 9), recurrent admissions (n = 9), technology dependence (n = 5), and uncertain prognosis (n = 1). Definitions were commonly referenced from another source (n = 6) or opinion-based (n = 5). The remaining 55 studies (82%) provided a definition for prolonged PICU admission, most frequently greater than or equal to 14 (n = 11) or greater than or equal to 28 days (n = 10). Most of these definitions were derived by investigator opinion (n = 24) or statistical method (n = 18). CONCLUSIONS: Pediatric CCI has been variably defined with regard to the concepts of patient complexity and chronicity of critical illness. A consensus definition is needed to advance this emerging and important area of pediatric critical care research.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Critical Care and Intensive Care Medicine,Pediatrics, Perinatology and Child Health

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