Understanding and preventing post-intensive care syndrome in children: a conceptual exploration

Introduction Post-intensive care syndrome in children has been conceptualized as the physical, psychological, cognitive, and social deficits that persist in patients for an extended period of time from the onset of critical illness until discharge from the pediatric intensive care unit. However, there is still no clear consensus on prevention strategies for the syndrome, despite the fact that nursing plays a fundamental role in its preventive approach. Objective To analyze the concept of “prevention of post-intensive care syndrome in children.” Method The concept analysis methodology proposed by Walker and Avant was used, based on a comprehensive review of the PubMed, Web of Science, Ovid, and ScienceDirect databases. Results and discussion Prevention of post-intensive care syndrome in children was identified as an emerging and multidimensional concept. Among the most relevant antecedents were increased survival following pediatric critical illness, growing evidence of persistent physical, cognitive, psychological, and social sequelae, and the subsequent recognition of PICS-p as a clinical construct. Potential consequences associated with the implementation of preventive approaches include better functional recovery, fewer long-term impairments, and greater support for children and their families. Pediatric adaptations of the ABCDEF bundle and family-centered care were identified as relevant conceptual and clinical frameworks, although evidence regarding their direct effectiveness in preventing PICS-p remains limited. Conclusions Prevention of post-intensive care syndrome in children is defined as a multidimensional and comprehensive process that includes the early implementation of physical, cognitive, psychological, and social strategies during and after hospitalization in the PICU, with the aim of anticipating, reducing, or avoiding the appearance of persistent sequelae in the child and their family environment. This prevention involves humane care, focused on development, active family participation, and continuous interdisciplinary work from admission to the transition home.