Reframing pediatric cardiac intensive care outcomes: The importance of the family and the role of pediatric medical traumatic stress

With mortality in the pediatric cardiac intensive care unit (CICU) low at 2-4%, the majority of children survive their admission. While the CICU experience is often part of a broader story of living with and managing cardiac disease, many children are impacted by CICU experience with changes to their physical health, neurocognition, psychological health, and quality of life. Risk factors for poor outcomes after a CICU admission include potentially fixed and immutable factors such as congenital heart disease severity, therapeutic interventions, and hospitalization characteristics. A potential key modifiable factor in child outcomes is the family's ability to facilitate a child's emotional and physical recovery after a CICU admission. For parents, though, having their child admitted to a CICU is often a traumatic experience that can result in posttraumatic stress disorder (PTSD), anxiety, depression, and family burden. Examining the family experience through the Integrative (Trajectory) Model of Pediatric Medical Traumatic Stress could identify modifiable factors to target with interventions for improving child and family outcomes after a CICU admission.