Protocol on an Integrative review on nomenclature and outcomes in paediatric complex critical illness - The basis for consensus definition

Paediatric Critical Care (PCC) supports the recovery of children with severe illness. Nationally, there are 30 PCC units with a total of approximately four hundred beds. There is constant demand for these beds with a mean five-day length of stay and admissions increasing at a greater rate than age-specific population growth [1, 2]. Prolonged stay patients account for approximately half of all PCC patient bed days [3]. Children with complex critical illness (CCI) need input from multiple different teams alongside support for their family [4, 5]. CCI often become prolonged PCC-stay patients too [6]. Internationally, there is variation in the definition of CCI [4, 8], this creates service variation and tensions around what resources can be provided including discharge planning, provision, and support. ObjectiveThe face of Paediatric Critical Care, in the UK and internationally has changed over the course of the last ten years with a growing cohort of complex critically ill patients. This integrative review aims to look at current nomenclature, definitions, and outcome measures of priority in this undefined patient population. Inclusion criteriaAll types of studies looking at children with complex critical illness (age <18 years) admitted to any paediatric intensive care unit (PICU). MethodsThe review is registered on Prospero. Medline, Embase, Maternity and Infant care, The Cochrane library, the Cumulative Index to Nursing and Allied Health literature (CINAHL) and Trip database will be searched from 2014 to May 2024. Search limits will include all languages, exclude the setting of neonatal intensive care and age>18 years old. Four independent reviewers will screen citations for eligible studies and perform data extraction. The final search strategy will be developed in Medline and peer-reviewed by a health research librarian not involved in the study. This will be translated to other databases as appropriate. Author approvalAll authors have seen and approved the manuscript.