Survival of pediatric intensive care unit (PICU) hospitalization for respiratory failure is associated with a reduction in IQ scores relative to matched biological siblings, according to a study published in the March 1 issue of the Journal of the American Medical Association.

R. Scott Watson, M.D., M.P.H., from the University of Washington in Seattle, and colleagues examined neurocognitive outcomes of children who survive PICU hospitalization for acute respiratory failure with their biological siblings in a prospective cohort study. Participants were aged 8 years or younger and had a Pediatric Cerebral Performance Category score of 1 (normal) before PICU admission and ≤3 (no worse than moderate neurocognitive dysfunction) at PICU discharge. Biological siblings were aged 4 to 16 years at testing and had a Pediatric Cerebral Performance Category score of 1. Data were included for 121 sibling pairs. Evaluations were conducted three to eight years after discharge from hospital.

The researchers found that compared with their matched siblings, patients had a lower mean estimated IQ (101.5 versus 104.3). In terms of secondary outcomes, significantly lower scores on nonverbal memory, visuospatial skills, and fine motor control were seen for patients, and they had significantly higher scores on processing speed than matched siblings. No significant differences were seen for the remaining secondary outcomes.

"Although the mean difference between patients and siblings would be small at an individual level, even small changes in mean IQ can have important implications depending on the distribution of scores," the authors write.

More information: R. Scott Watson et al, Association of Acute Respiratory Failure in Early Childhood With Long-term Neurocognitive Outcomes, JAMA (2022). DOI: 10.1001/jama.2022.1480

Steven L. Shein et al, Long-term Neurocognitive Morbidity After a Single Episode of Respiratory Failure in Children, JAMA (2022). DOI: 10.1001/jama.2021.24279

Journal information: Journal of the American Medical Association 

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