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J Pediatr Intensive Care 2024; 13(04): 408-414
DOI: 10.1055/s-0042-1756307
Original Article

Oxygenation Severity Categories and Long-Term Quality of Life among Children who Survive Septic Shock

Joseph G. Kohne 
1   Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, United States
2   Susan B. Meister Child Health Evaluation and Research Center, University of Michigan School of Medicine, Ann Arbor, Michigan, United States
,
Erin F. Carlton
1   Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, United States
2   Susan B. Meister Child Health Evaluation and Research Center, University of Michigan School of Medicine, Ann Arbor, Michigan, United States
,
Stephen M. Gorga
1   Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, United States
,
Acham Gebremariam
2   Susan B. Meister Child Health Evaluation and Research Center, University of Michigan School of Medicine, Ann Arbor, Michigan, United States
,
Michael W. Quasney
1   Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, United States
,
Jerry Zimmerman
3   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, Washington, United States
,
Sarah L. Reeves
2   Susan B. Meister Child Health Evaluation and Research Center, University of Michigan School of Medicine, Ann Arbor, Michigan, United States
4   Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States
,
Ryan P. Barbaro
1   Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, United States
2   Susan B. Meister Child Health Evaluation and Research Center, University of Michigan School of Medicine, Ann Arbor, Michigan, United States
› Author Affiliations Funding This research was conducted without external funding.
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Abstract

Objectives This study aimed to test whether early oxygenation failure severity categories (absent/mild/moderate/severe) were associated with health-related quality of life (HRQL) deterioration among children who survived sepsis-related acute respiratory failure.

Methods We performed a secondary analysis of a study of community-acquired pediatric septic shock, Life After Pediatric Sepsis Evaluation. The primary outcome was an adjusted decline in HRQL ≥ 25% below baseline as assessed 3 months following admission. Logistic regression models were built to test the association of early oxygenation failure including covariates of age and nonrespiratory Pediatric Logistic Organ Dysfunction-2 score. Secondarily, we tested if there was an adjusted decline in HRQL at 6 and 12 months and functional status at 28 days.

Results We identified 291 children who survived to discharge and underwent invasive ventilation. Of those, that 21% (61/291) had mild oxygenation failure, 20% (58/291) had moderate, and 17% (50/291) had severe oxygenation failure. Fifteen percent of children exhibited a decline in HRQL of at least 25% from their baseline at the 3-month follow-up time point. We did not identify an association between the adjusted severity of oxygenation failure and decline in HRQL ≥ 25% at 3-, 6-, or 12-month follow-up. Children with oxygenation failure were more likely to exhibit a decline in functional status from baseline to hospital discharge, but results were similar across severity categories.

Conclusion Our findings that children of all oxygenation categories are at risk of HRQL decline suggest that those with mild lung injury should not be excluded from comprehensive follow-up, but more work is needed to identify those at the highest risk.

Keywords

shock, septic - health-related quality of life - acute hypoxemic respiratory failure - respiratory distress syndrome, pediatric - postintensive care syndrome - functional status

Supplementary Material



Publication History

Received: 04 April 2022

Accepted: 08 July 2022

Article published online:
14 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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