Authors (including presenting author) :
Hui WW(1), Leung KKY(2), Poon MC(1), Lau HCS(1), Chan MYR(1), Lam J(1), Cheng WC(1), Hon KL(2), Stephen Chan WW(1)
Affiliation :
(1)Allied Health Department (Physiotherapy), Hong Kong Children’s Hospital (2)Paediatric Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital
Keyword 1: :
paediatric intensive care unit
Keyword 3: :
critical care
Keyword 4: :
follow-up clinic
Keyword 5: :
multidisciplinary
Keyword 6: :
physiotherapy
Introduction :
Paediatric critical care survivors are frequently associated with post-intensive care syndrome in children, with persistent physical, cognitive, psychological, and social morbidities affecting long-term functional outcomes and quality of life. To address this, Hong Kong Children’s Hospital established its first multidisciplinary paediatric post-critical care follow-up clinic in 2021. Led by a Paediatric Intensive Care Unit (PICU) physician and integrated with physiotherapy team, this clinic facilitates systematic identification of residual impairments and prompts multidisciplinary intervention. Physiotherapy team plays a central role in functional assessment and rehabilitation planning.
Objectives :
(1)To identify developmental, physical, cognitive, psychological and social impairments after PICU discharge (2)To facilitate timely multidisciplinary intervention through a structured post-critical care clinic model
Methodology :
This study evaluated a multidisciplinary post-critical care follow-up clinic model. Children admitted to PICU for ≥72 hours were identified with pre-discharge planning to facilitate transition to outpatient follow-up. Around 6 months post-discharge, patients attended the PICU physician led clinic with physiotherapy team providing comprehensive assessment focusing on functional assessment, lung function, quality of life, development and cognitive screening. Targeted rehabilitation and psychosocial support service were referred as indicated. Patient demographics, diagnostic case mix, PICU length of stay and subsequent referral to physiotherapy services were recorded.
Result & Outcome :
Between 30 September 2021 to 31 December 2025, 290 post-PICU discharge patients attended the clinic. Patients were reviewed at a median of 6.3 (range: 2 – 28.3) months post-PICU discharge. Median age of the patients was 3 (range: from 0 - 20) years old. The diagnostic case mix included post-cardiac surgery (38%), oncology (21%), general paediatric surgery (14%), ECMO (9%), respiratory (4%) and neurology (2%). The median PICU length of stay was 6 (range: 3 - 225) days. Among the clinic attendees, 7 (2.4%) patients demonstrated persistent physical impairments, requiring further intervention, with a total of 15 additional outpatient physiotherapy sessions provided.
