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Background <p>Severe complications of common community-acquired infections can necessitate pediatric intensive care even in previously healthy children. While survival after pediatric intensive care has improved, data on long-term physical, cognitive, and psychosocial outcomes in this population remain limited. This study evaluated 12-month outcomes in previously healthy children admitted to the pediatric intensive care unit for severe infectious complications and describes the implementation of a structured post-intensive care follow-up program at a tertiary care center in Germany.</p> Methods <p>We conducted a retrospective single-center study including previously healthy children admitted to the PICU in 2023 due to severe complications of community-acquired infections. Patients participated in a structured multidisciplinary follow-up program with standardized neurological, physical, cognitive, and psychosocial assessments performed up to 12 months after discharge.</p> Results <p>Thirty-seven previously healthy children admitted in 2023 were included. The largest subgroup of the study population consisted of children with intracranial abscess or meningitis (43%), orbital abscess (27%), septic shock (14%), osteomyelitis (11%), and necrotizing fasciitis (5%). Despite appropriate acute management and survival of all patients, 25 children (68%) developed persistent neurological, somatic, or psychosocial impairments during follow-up. Common sequelae included motor deficits, neurocognitive dysfunction, sensory impairment, anxiety, and reduced physical endurance. Importantly, many complications were not apparent early after discharge and emerged several months later, with a median time to identification of approximately five months. Recovery trajectories varied considerably, reflecting the multidimensional nature of pediatric post–intensive care morbidity.</p> Conclusions <p>A substantial proportion of previously healthy children experience clinically relevant, multidimensional morbidity after severe infections requiring intensive care. These findings highlight the importance of structured, multidisciplinary post-intensive care follow-up to enable early recognition of delayed sequelae and timely intervention, with the potential to reduce long-term morbidity and improve quality of life for affected children and their families.</p>

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Post–intensive care sequelae after severe bacterial infections in previously healthy children

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月1日

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  • S. C. Goretzki,
  • C. Held,
  • S. Tschirner,
  • C. Pentek,
  • H. Kölbel,
  • A. Della Marina,
  • A. Gangfuß,
  • H. Reusch,
  • N. Schlaghecke,
  • S. Benson,
  • U. Schara-Schmidt,
  • U. Felderhoff-Müser,
  • C. Dohna-Schwake,
  • N. Bruns

摘要

Background

Severe complications of common community-acquired infections can necessitate pediatric intensive care even in previously healthy children. While survival after pediatric intensive care has improved, data on long-term physical, cognitive, and psychosocial outcomes in this population remain limited. This study evaluated 12-month outcomes in previously healthy children admitted to the pediatric intensive care unit for severe infectious complications and describes the implementation of a structured post-intensive care follow-up program at a tertiary care center in Germany.

Methods

We conducted a retrospective single-center study including previously healthy children admitted to the PICU in 2023 due to severe complications of community-acquired infections. Patients participated in a structured multidisciplinary follow-up program with standardized neurological, physical, cognitive, and psychosocial assessments performed up to 12 months after discharge.

Results

Thirty-seven previously healthy children admitted in 2023 were included. The largest subgroup of the study population consisted of children with intracranial abscess or meningitis (43%), orbital abscess (27%), septic shock (14%), osteomyelitis (11%), and necrotizing fasciitis (5%). Despite appropriate acute management and survival of all patients, 25 children (68%) developed persistent neurological, somatic, or psychosocial impairments during follow-up. Common sequelae included motor deficits, neurocognitive dysfunction, sensory impairment, anxiety, and reduced physical endurance. Importantly, many complications were not apparent early after discharge and emerged several months later, with a median time to identification of approximately five months. Recovery trajectories varied considerably, reflecting the multidimensional nature of pediatric post–intensive care morbidity.

Conclusions

A substantial proportion of previously healthy children experience clinically relevant, multidimensional morbidity after severe infections requiring intensive care. These findings highlight the importance of structured, multidisciplinary post-intensive care follow-up to enable early recognition of delayed sequelae and timely intervention, with the potential to reduce long-term morbidity and improve quality of life for affected children and their families.