The effects of critical illness in early childhood on neurocognitive outcomes

Approximately 23,700 children in the U.S. undergo invasive mechanical ventilation for acute respiratory failure annually. Although most survive, little is known if they have worse long-term neurocognitive function than children who do not undergo such procedures. There are concerns about neurotoxic effects of critical illness and its treatment on the developing brain. Therefore, infants and young children may be uniquely susceptible to adverse neurocognitive outcomes after invasive mechanical ventilation.

Two children lying on the floor talking over notebooks.

A four-year sibling-matched cohort study conducted at 31 U.S. PICUs and associated neuropsychology testing centers, published in JAMA, sheds light on the subject. Researchers found that children who survived PICU hospitalization for respiratory failure and were discharged without severe cognitive dysfunction had significantly lower subsequent IQ scores than their matched siblings.

“While the difference in IQ scores between patients and unexposed siblings was small, the data provide strong evidence of the existence and epidemiology of pediatric post-intensive care syndrome (PICS-p) after a single typical episode of acute respiratory failure necessitating invasive ventilation among generally healthy children,” says Martha A.Q. Curley, professor of nursing at Penn Nursing and the study’s lead researcher.

The study reaffirms the importance of assessing long-term outcomes as part of any trial evaluating acute interventions in pediatric critical care.

Read more at Penn Nursing News.