Long-term Psychological Morbidity Among Children Surviving Critical Illness and Injury

Peter Safar, one of the fathers of critical care, once astutely noted that critical illness neither begins nor ends at the walls of the intensive care unit or even the hospital. Children may begin their encounter with critical illness with the ongoing impact of preexisting chronic comorbid conditions. They then experience organ dysfunction that dictates the intensity and duration of critical care and serves as an important antecedent for risk of mortality and long-term morbidity. Interventions required to support organ dysfunction, such as sedation to facilitate mechanical ventilation, similarly may be associated with adverse long-term sequalae among children surviving critical illness. In addition, the health of family dynamics after hospital discharge plays an important role in a child’s recovery back to baseline.