J Pediatr Intensive Care
DOI: 10.1055/s-0044-1788917
1
Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
,
Russell K. Banks
1
Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
,
Ron Reeder
1
Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
,
Rylee Beckstead
1
Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
,
Cornelius Groenwald
2
Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Palo Alto, California, United States
,
Kathleen L. Meert
3
Departent of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan, United States
4
Department of Pediatrics, Central Michigan University, Mt. Pleasant, Michigan, United States
,
Jerry J. Zimmerman
5
Department of Pediatrics, Seattle Children's Hospital, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, Washington, United States
,
Tonya M. Palermo
6
Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, Washington, United States
,
Jennifer K. Workman
1
Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
› Author Affiliations
Funding This investigation was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, R01HD073362 (J.J.Z.), and was supported, in part, by the following cooperative agreements associated with the Collaborative Pediatric Critical Care Research Network: UG1HD050096 (K.L.M.), UG1HD049981, UG1HD049983, UG1HD063108, UG1HD083171, UG1HD083166, UG1HD083170, U10HD050012, U10HD063106, and U01HD049934. Additional funding was provided by R03HD104001 (R.R.) and K23HL138155 (C.G.).
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Abstract
Children who survive septic shock are at high risk of new morbidity. The objective of this study is to evaluate the occurrence and risk factors associated with new or worsening sleep disturbance, comparing baseline to 3 months following admission among children surviving septic shock. A secondary analysis of the Life After Pediatric Sepsis Evaluation prospective cohort study was performed. This study included children <18 years admitted to 12 U.S. Pediatric Intensive Care Units with community-acquired septic shock requiring vasoactive–inotropic support and invasive or noninvasive ventilation who survived discharge. The primary outcome of sleep deterioration was characterized as any increased trouble in sleeping measured by a question from the Pediatric Quality of Life Inventory (PedsQL) at baseline compared with the response at the 3-month follow-up. Child and parent variables were evaluated for association with sleep deterioration using univariable and multivariable analyses. Of the original 389 patients, 229 survived for 3 months and completed the PedsQL. The final cohort included 111 children who had available follow-up data at month 3 and did not report baseline sleep challenges. Overall, 25% (28/111) of children reported declines in sleep at 3 months. There were no patient or illness characteristics associated with sleep decline at 3 months in univariable analysis. In multivariable models controlling for age, sex, insurance type, baseline complex conditions, and immunocompromise, no measures of illness severity were associated with deterioration in sleep at 3 months. Sleep deterioration is common in survivors of community-acquired septic shock but detection may be difficult to identify without routine screening.
Keywords
septic shock -
postintensive care syndrome—pediatric -
sleep -
quality of life
Publication History
Received: 04 April 2024
Accepted: 18 July 2024
Article published online:
26 August 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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