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Children 2017, 4(9), 83; https://doi.org/10.3390/children4090083

If You Build It, They Will Come: Initial Experience with a Multi-Disciplinary Pediatric Neurocritical Care Follow-Up Clinic

1
Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health and Science University, 707 SW Gaines St, CDRC-P, Portland, OR 97239, USA
2
Division of Pediatric Neurology, Department of Pediatrics, Oregon Health and Science University, 707 SW Gaines St, CDRC-P, Portland, OR 97239, USA
*
Author to whom correspondence should be addressed.
Received: 24 August 2017 / Revised: 13 September 2017 / Accepted: 14 September 2017 / Published: 19 September 2017
(This article belongs to the Section Child Neurology)
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Abstract

Pediatric Neurocritical Care diagnoses account for a large proportion of intensive care admissions. Critical care survivors suffer high rates of long-term morbidity, including physical disability, cognitive impairment, and psychosocial dysfunction. To address these morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals apply to all Pediatric Neurocritical Care patients regardless of admission severity of illness. Here, we report an initial case series, which revealed a population that is heterogenous in age, ranging from 1 month to 18 years, and in diagnoses. Traumatic brain injuries of varying severity as well as neuroinfectious and inflammatory diseases accounted for the majority of referrals. Most patients (87%) seen in the clinic had morbidities identified, requiring ongoing evaluation and expansion of the clinic. Cognitive and psychological disturbance were seen in over half of patients at the initial clinic follow-up. Sleep disturbances, daytime fatigue, headache or chronic pain, and vision or hearing concerns were also common at initial follow-up. Data from this initial population of clinic patients reiterates the need for specialized follow-up care, but also highlights the difficulties related to providing this comprehensive care and evaluating interventions to improve outcomes. View Full-Text
Keywords: pediatric; critical care outcomes; brain injuries; meningitis; encephalitis; stroke pediatric; critical care outcomes; brain injuries; meningitis; encephalitis; stroke
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Williams, C.N.; Kirby, A.; Piantino, J. If You Build It, They Will Come: Initial Experience with a Multi-Disciplinary Pediatric Neurocritical Care Follow-Up Clinic. Children 2017, 4, 83.

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