Application of Telemedicine Technology to Facilitate Diagnosis of Pediatric Postintensive Care Syndrome

Abstract

Background:

Postintensive care syndrome (PICS) is well-defined in the adult literature but has not received much attention in pediatrics.

Introduction:

We sought to use a telemedicine platform for the characterization of PICS by creating a convenient and effective virtual follow-up clinic.

Materials and Methods:

Prospective single-center study in a pediatric intensive care unit (ICU) of patients aged 4–17 years who underwent any invasive procedures while admitted to the ICU. Parents completed the Weiss Functional Impairment Rating Scale (WFIRS) based on baseline behaviors before ICU admission, with the scale readministered at 1 week, 1 month, and 3 months postdischarge via secure telehealth platform. Patients with a WFIRS baseline raw score of 10 or an interval increase of 2 were referred to psychiatry for evaluation and treatment.

Results:

Fifty patients were enrolled. Risk factors for PICS included number of procedural interventions, length of pediatric ICU stay, number of specialty consults, sex, race, and duration of sedation/airway instrumentation. In univariate analysis, age appeared to be the only statistically significant factor associated with the development of PICS. Variables associated with a higher change in WFIRS score showed a statistically significant correlation with the number of procedures completed, the number of specialists involved, and the need for a psychiatric referral. Only 34% of total telemedicine follow-ups were completed.

Discussion:

There is an association between age and the development of PICS and between change in WFIRS score and number of procedures, specialist involved, and psychiatric referral.

Conclusions:

The use of telemedicine did not result in an improved follow-up rate when compared to outpatient clinic studies.