Brain-related outcome measures in trials recruiting critically-ill children. Issue 6 (December 2019)

• Record Type: Journal Article
• Authors: Fink, Ericka L.; Tasker, Robert C.
• Is Part Of: Current opinion in pediatrics. Volume 31:Issue 6(2019:Dec.)
• Publication Date: 2019-12
• Subjects: morbidity -- outcomes -- pediatric intensive care -- randomized controlled trials; Pediatrics -- Periodicals; Pediatrics -- Periodicals -- Bibliography -- Periodicals; 618.92
• DOI: 10.1097/MOP.0000000000000826
• Languages: English
• ISSNs: 1040-8703

Abstract

Abstract : Purpose of review: Randomized controlled trials leading to innovations that improve outcomes in acute life-threatening illnesses in children are scarce. A key issue is how we refocus research on outcomes that matter and are more relevant to those making emergency decisions, and those involved with managing and living with the late-outcome. We have used information from recent trials in critically ill children – in particular those illnesses without any primary neurologic involvement – to develop an approach to brain-related outcomes that will maximize child and family benefit from research. Recent findings: Fifteen recent pediatric critical care trials illustrate four types of brain-related outcomes assessment: death or organ-system-failures – as illustrated by studies in systemic illness; neurological and neuropsychological outcomes – as illustrated by the glycemic control studies; cognitive outcomes – as illustrated by a sedative trial; and composite outcomes – as illustrated by the therapeutic hypothermia studies. Summary: The 15 research trials point to five areas that will need to be addressed and incorporated into future trial design, including use of: neurologic monitoring during intensive care unit admission; postdischarge outcomes assessments; strategies to improve retention in long-term follow-up; child and family-centered outcomes; and core outcomes datasets.