Gross motor developmental dysfunctional outcomes in infantile and toddler pediatric intensive care unit survivors

Chun-Feng Yang,Fei-Yong Jia,Jun-Yan Feng,Yu-Mei Li,Yang Xue,Yu Zhang

doi:10.1186/s12887-019-1893-9

Chun-Feng Yang, Fei-Yong Jia + Show 4 more

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https://doi.org/10.1186/s12887-019-1893-9

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Abstract

BackgroundIncreasing studies have focused on motor function/dysfunction in PICU survivors; however, most studies have focused on adults and older children. This study investigated gross motor developmental function outcomes in infantile and toddler pediatric intensive care unit (PICU) survivors and the factors associated with gross motor developmental functions.MethodsThis observational study was conducted in the PICU of the First Hospital of Jilin University between January 2019 and March 2019. Thirty-five eligible patients were divided into the dysfunctional (n = 24) or non-dysfunctional (n = 11) group according to the results of the Peabody Developmental Motor Scales, Second Edition (PDMS-2). Baseline gross motor function for all participants before PICU admission was measured via the Age and Stages Questionnaires, Third Edition (ASQ-3). The PDMS-2 was used to evaluate gross motor development function before PICU discharge.ResultsThe gross motor developmental dysfunction incidence was 68.6%. Linear correlation analysis showed that the gross motor quotient (GMQ) was positively correlated with the pediatric critical illness score (PCIS, r = 0.621, P < 0.001), and negatively correlated with length of PICU stay (r = − 0.556, P = 0.001), days sedated (r = − 0.602, P < 0.001), days on invasive mechanical ventilation (IMV; r = − 0.686, P < 0.001), and days on continuous renal replacement therapy (CRRT; r = − 0.538, P = 0.001). Linear regression analysis showed that IMV days (β = − 0.736, P = 0.001), sepsis (β = − 18.111, P = 0.003) and PCIS (β = 0.550, P = 0.021) were independent risk factors for gross motor developmental dysfunction.ConclusionsGross motor developmental dysfunction in infantile and toddler PICU survivors is more common and may be exacerbated by experiences associated with longer IMV days and increasing illness severity combined with sepsis.Trial registrationThe trial ‘Early rehabilitation intervention for critically ill children’ has been registered at http://www.chictr.org.cn/showproj.aspx?proj=23132. Registration number: ChiCTR1800020196.

Highlights

With improved diagnostic and treatment technology in pediatric critical care medicine, mortality rates have decreased significantly among critically ill children
Sex, diagnostic category, percentage of surgical patients, percentage of sepsis, use of vasoactive medications, pediatric critical illness score (PCIS), length of pediatric intensive care unit (PICU) stay, invasive mechanical ventilation (IMV) days, days on sedatives, days on methylprednisolone and continuous renal replacement therapy (CRRT) days were recorded for both groups (Table 1)
The results showed that gross motor quotient (GMQ) was positively correlated with PCIS (r = 0.621, P < 0.001), while length of PICU stay (r = − 0.556, P = 0.001), days sedated (r = − 0.602, P < 0.001), IMV days(r = − 0.686, P < 0.001), and CRRT days (r = − 0.538, P = 0.001) were negatively correlated with the GMQ (Fig. 2a–f)

Summary

Introduction

With improved diagnostic and treatment technology in pediatric critical care medicine, mortality rates have decreased significantly among critically ill children Treatments such as invasive mechanical ventilation (IMV), drugs and other factors, can cause newly acquired functional disabilities, in addition to saving the. Gross motor developmental function assessment is mostly used in neonatal intensive care units (NICUs) and in high-risk infants [11, 12]. Our study investigated the gross motor developmental function outcomes of infantile and toddler survivors of pediatric intensive care units (PICUs) and is the first to assess gross motor developmental function in infants and toddlers in a PICU. This study investigated gross motor developmental function outcomes in infantile and toddler pediatric intensive care unit (PICU) survivors and the factors associated with gross motor developmental functions

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