TY  - CHAP
M1  - Book, Section
TI  - Pediatrics
A1  - Pinto, Neethi P.
A1  - Choong, Karen
A1  - Kudchadkar, Sapna R.
A1  - Hall, Trevor
A1  - Manning, Joseph C.
A1  - Nadkarni, Vinay
A2  - Lane-Fall, Meghan B
A2  - Shapiro, David S.
A2  - Kaplan, Lewis J.
PY  - 2024
T2  - After the ICU: Multidisciplinary Perspectives on Supporting Critical Illness Survivors
AB  - Patient  Care  VignetteTwelve-year-old  Maya  wasn’t  quite  herself  at  her  Saturday  soccer  game,  complaining  of  headache.  The  next  morning  she  couldn’t  walk  to  the  bathroom.  Her  parents  took  her  to  the  emergency  department  where  her  symptoms  worsened.  By  early  Monday,  Maya  had  difficulty  breathing.  She  was  quickly  transported  to  the  nearest  pediatric  intensive  care  unit  (PICU)  across  the  state  border.  Upon  arrival,  she  was  intubated  and  found  to  be  completely  paralyzed  with  the  exception  of  the  ability  to  open  her  eyes.  Initially,  Maya’s  differential  diagnosis  included  a  paralysis  recently  seen  among  children  in  the  western  United  States  who  had  been  infected  with  Enterovirus  d68  as  well  as  Guillain-Barre  syndrome  (GBS).  Even  after  confirmation  of  a  diagnosis  of  atypical  GBS,  Maya’s  family  faced  uncertainty  about  her  long-term  prognosis.  The  medical  team  told  them  that  Maya  might  not  regain  function  of  her  arms  or  legs.  Maya’s  family,  school,  and  church  communities  were  instrumental  in  supporting  Maya  and  her  family  during  their  arduous  journey,  taking  turns  to  stay  with  Maya’s  siblings  while  her  parents  juggled  being  at  the  hospital,  work,  or  home.The  medical  team  was  also  tireless;  after  several  courses  of  plasmapheresis  and  intravenous  immunoglobulin  treatment  in  tandem  with  ongoing  physical,  occupational,  and  speech  therapy,  Maya  slowly  regained  the  ability  to  move.  After  a  few  weeks  in  the  PICU,  she  underwent  tracheostomy  tube  placement  to  facilitate  chronic  mechanical  ventilation  support,  ongoing  therapies,  and  discharge  to  a  rehabilitation  facility.  After  1  month,  she  was  discharged  home,  and  within  6  months,  Maya  made  a  full  physical  and  psychological  recovery—walking  without  assistance,  undergoing  tracheostomy  decannulation,  playing  soccer  again,  returning  to  school,  and  eventually  graduating  from  high  school  on  time  with  plans  to  attend  college.  Her  parents  and  siblings  were  also  able  to  resume  work  and  return  to  leisure  routines  that  had  been  interrupted  and  put  on  hold  during  Maya’s  PICU  admission  and  lengthy  recovery.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/10/10
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1204537692
ER  -