Grant: Travel Awards - Institute Community Support

Background: Improved mortality amongst critically ill adults has lead to the recognition of a "post-intensive care syndrome", a phenomenon of acquired functional, cognitive and mental health sequelae amongst survivors. There is a paucity of research evaluating the impact of a critical illness on functional outcomes in children. Objectives:To describe the functional recovery following prolonged immobility and delayed rehabilitation AND to explore the predictors of impaired functional recovery following immobilization in critically ill children. Methods:Prospective Observational Pilot Study, Single Centre. Children aged < 18 years, admitted to PCCU , between October 2012 to April 2013, with > 48h length stay, > one organ dysfunction on PCCU admission were included. Primary Outcome: Feasibility (enrolment rate and protocol adherence). Secondary outcomes: 1)Functional Recovery over time (at baseline, 3 and 6 months, as measured by the following validated tools: Pediatric Disability Inventory (PEDI) and Participation and Environment Measure- children and youth (PEM-CY). 2) Parental Stress Index (PSI) at 3 months. Exercise testing was conducted on a subset of patients. Result: Feasibility was demonstrated. We enrolled 30 patients in 6 months, consent rate was excellent (89%), and we were able to execute the study procedures.Follow-up rate was 87% at 3 months, and 69% at 6 months.Preliminary data suggests that a significant proportion of children are not at baseline functional status at 6 months, and that underlying health and functional status may influence functional recovery. Conclusions:This is the first study to our knowledge to evaluate the functional outcomes, as defined by the International Classification of Functioning, Disability, and Health (ICF) in a general critically ill pediatric population.This pilot study confirmed feasibility, justified the need for further research.