P0482 / #1466: POST-INTENSIVE CARE SYNDROME AMONG SURVIVORS OF CRITICAL BRONCHIOLITIS

Abstract

Aims & Objectives: We previously showed that ~15% of previously healthy PICU patients with bronchiolitis have evidence of post-intensive care syndrome (PICS) in administrative databases. Now, we aimed to evaluate for post-bronchiolitis PICS using detailed, in-person testing. Methods: Critical bronchiolitis patients discharged from our urban, academic PICU 1-3 years ago were invited via mail for in-person testing with Bayley Scales of Infant & Toddler Development (Bayley-III), Ages and Stages Questionnaire, and Pediatric Evaluation of Disability Inventory-Computer Adaptive Test. Children with pre-PICU developmental delay (per the admission medical records or parental recall) were excluded. For each domain (motor, language, etc.) of each test, mild dysfunction (>1SD below the mean) and severe dysfunction (>2SD below) were identified. PICS was defined as severe dysfunction in ≥3 of the 11 total domains or mild dysfunction in ≥5 domains. Data shown as median (IQR). Results: With IRB approval, 20 children (80% without previous hospitalizations) underwent testing at 2.1 (1.8-2.8) years after PICU care. Most had been supported by HFNC (95%) and/or invasive ventilation (20%). PICS was identified in 35% of cases, including 25% with severe dysfunction in ≥3 domains. For the whole group, median scores in each Bayley-III domain were below normal (Cognitive: 25th [16th-37th] percentile; Language: 31st [6th-50th] percentile; Motor: 21st [12th-29th] percentile). Excluding children born prematurely or with cyanotic congenital heart disease, PICS was observed in 5 of 15 subjects. Conclusions: PICS is common after critical bronchiolitis, even among generally healthy children. Future studies should prospectively compare scores measured at and after PICU admission.