Severe bacterial infections requiring PICU admission in previously healthy children – Insights from a structured pediatric intensive care follow-up program

Objective This study aimed to evaluate physical, cognitive, and psychosocial outcomes in previously healthy children admitted to the Pediatric Intensive Care Unit (PICU) with severe complications arising from initially common community-acquired infections, and to describe the first-year experience of a structured post-intensive care follow-up program at a tertiary care hospital in Germany. Currently Germany lacks standardized follow-up structures for PICU survivors, despite growing recognition of long-term morbidity. Design: Clinical and follow-up data were obtained retrospectively from in- and outpatient medical records of all PICU patients meeting inclusion criteria during the study period. Demographic, clinical, and follow-up data were extracted anonymously. Multidomain outcomes were assessed at 4 weeks, 3, 6, and 12 months after discharge, including physical, neurocognitive, and psychosocial parameters. Setting: Tertiary care University center in Germany. Patients: All previously healthy children (n = 37, age > 28 days and < 18 years) admitted to the PICU in 2023 due to severe infectious complications, including intracranial abscess or meningitis (43%), orbital abscesses (27%), septic shock (14%), osteomyelitis (11%), and necrotizing fasciitis (5%). Interventions: None. Measurements and Main Results: Despite appropriate acute management during the PICU stay, 25 children (68%) developed prolonged neurological, somatic, or psychosocial impairments, including motor deficits, neurocognitive dysfunction, and anxiety. Many sequelae emerged around 5 months after discharge. The heterogeneous recovery trajectories emphasize the clinical relevance of Pediatric Post-Intensive Care Syndrome (PICS-p). Conclusions Our findings highlight the need for multidisciplinary post-PICU follow-up, particularly for previously healthy children. Early recognition and targeted interventions may reduce long-term morbidity and improve quality of life for affected children and their families.