title: Functional recovery following critical illness in children: the "wee-cover" pilot study.
abstract: OBJECTIVE
  To determine the feasibility of conducting a longitudinal prospective study to evaluate functional recovery and predictors of impaired functional recovery in critically ill children.
  
  
  METHODS
  Prospective pilot study.
  
  
  METHODS
  Single-center PICU at McMaster Children's Hospital, Hamilton, Canada.
  
  
  METHODS
  Children aged 12 months to 17 years, with at least one organ dysfunction, limited mobility or bed rest during the first 48 hours of PICU admission, and a minimum 48-hour PICU length of stay, were eligible. Patients transferred from a neonatal ICU prior to ever being discharged home, already mobilizing well or at baseline functional status at time of screening, with an English language barrier, and prior enrollment into this study, were excluded.
  
  
  METHODS
  None.
  
  
  RESULTS
  The primary outcome was feasibility, as defined by the ability to screen, enroll eligible patients, and execute the study procedures and measurements on participants. Secondary outcomes included functional status at baseline, 3 and 6 months, PICU morbidity, and mortality. Functional status was measured using the Pediatric Evaluation of Disability Inventory and the Participation and Environment Measure for Children and Youth. Thirty-three patients were enrolled between October 2012 and April 2013. Consent rate was 85%, and follow-up rates were 93% at 3 months and 71% at 6 months. We were able to execute the study procedures and measurements, demonstrating feasibility of conducting a future longitudinal study. Functional status deteriorated following critical illness. Recovery appears to be influenced by baseline health or functional status and severity of illness.
  
  
  CONCLUSIONS
  Longitudinal research is needed to understand how children recover after a critical illness. Our results suggest factors that may influence the recovery trajectory and were used to inform the methodology, outcomes of interest, and appropriate sample size of a larger multicenter study evaluating functional recovery in this population.
authors: 1Department of Pediatrics, Critical Care, Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. 2Division of Pediatric Critical Care, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. 3Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. 4Department of Pediatrics, and Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. 5CanChild Centre for Childhood Disability, McMaster University, Hamilton, Ontario, Canada. 6Department of Occupational Therapy, Colorado State University, Fort Collins, CO.
authors: Karen
authors: K
authors: Choong
authors: Samah
authors: S
authors: Al-Harbi
authors: Katie
authors: K
authors: Siu
authors: Katie
authors: K
authors: Wong
authors: Ji
authors: J
authors: Cheng
authors: Burke
authors: B
authors: Baird
authors: David
authors: D
authors: Pogorzelski
authors: Brian
authors: B
authors: Timmons
authors: Jan-Willem
authors: JW
authors: Gorter
authors: Lehana
authors: L
authors: Thabane
authors: Mary
authors: M
authors: Khetani
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
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