背景:在全球范围内,脓毒症已被确定为可预防的儿童死亡率和发病率的主要原因之一.先前对重症监护患者的研究估计,大约30%的败血症儿童在出院时经历某种形式的残疾。护理的发展已经看到越来越多的接受败血症治疗的儿童不需要PICU入院;然而,这一人群的结果尚待了解。需要进一步关注,以了解更广泛人群中的败血症存活率,以解决更广泛存活人群中的知识差距和发病率负担。
目的:为了评估认知,物理,住院2年后存活的脓毒症儿童的情绪和社会健康。
方法:前瞻性,观察性队列研究。
结果:将对两百三十二名儿童进行筛查,入院2年后,并寻求参与这项研究。随访时年龄小于18岁的儿童,纳入2018年10月至2019年12月期间在昆士兰州接受脓毒症相关器官功能障碍或脓毒性休克治疗的患者.在后续行动中死亡的儿童,在国家的照顾下,或要求英语口译员将被排除在参与之外。数据将通过在线随访调查收集,其中包括经过验证的护理人员报告的问卷,涵盖四个重症监护综合症儿科(PICS-p)领域(认知,物理,情感和社会健康;曼宁等人。PediatrCritCareMed,2018,19,298-300)。主要结果是使用Vinelands-3工具评估的参与者的适应性行为。次要结果将包括神经发育,生活质量,儿童苦恼,整体功能,执行功能,照顾者的痛苦和照顾者的压力。方差分析(ANOVA),Kruskal-Wallis和Fisher精确检验/卡方检验将用于统计分析。不会对多重比较进行调整,但承认本研究中的比较是探索性的。
结论:随着更多的脓毒症患儿存活,有必要对患者和家属结局进行更全面的评估,以便为败血症后出院的家属提供支持.这项研究预计将告知临床医生和利益相关者败血症后患者和家庭的福祉。
Globally, sepsis has been identified as one of the leading causes of preventable childhood mortality and morbidity. Previous studies on intensive care patients estimated that approximately 30% of children with sepsis experience some form of disability at discharge. Development of care has seen growing numbers of children treated for sepsis not requiring a PICU admission; however, outcomes in this population are yet to be understood. Further focus is required to understand sepsis survivorship across the wider population to address knowledge gaps and morbidity burden in the broader surviving population.
To assess the cognitive, physical, emotional and social health of children surviving sepsis 2 years after hospital discharge.
A prospective, observational cohort study.
Two hundred and thirty-two children will be screened, 2 years after their hospital admission, and approached for participation in this study. Children who are <18 years of age at follow-up, treated for sepsis-related organ dysfunction or septic shock in Queensland between October 2018 and December 2019, will be included. Children who are deceased at follow-up, under care of the state, or require English interpreters will be excluded from participation. Data will be collected through an online follow-up survey comprising validated caregiver-reported questionnaires covering the four Post Intensive Care Syndrome-paediatrics (PICS-p) domains (cognitive, physical, emotional and social health; Manning et al. Pediatr Crit Care Med, 2018, 19, 298-300). The primary outcome is an adaptive behaviour of the participants assessed using the Vinelands-3 tool. Secondary outcomes will include neurodevelopment, quality of life, child distress, overall function, executive function, caregiver\'s distress and caregiver\'s stress. Analysis of variance (ANOVA), Kruskal-Wallis and Fisher\'s exact test/chi-squared tests will be used for statistical analyses. No adjustments will be made for multiple comparisons but it is acknowledged that comparisons made in this study are exploratory.
With more children surviving sepsis, there is a need for a more comprehensive assessment of patient and family outcomes to allow support structures for families leaving the hospital after sepsis. This study is expected to inform clinicians and stakeholders of patient and family well-being after sepsis survivorship.