Critical Illness Recovery Center for ChiLdrEn Expands Services

The Critical Illness Recovery Center for ChiLdrEn (CIRCLE) has launched a longitudinal outcomes program that focuses on children with a newly acquired brain injury (ABI). Critical illness and a stay in an ICU are associated with functional impairment in children and families. The impairment is termed Post-Intensive Care Syndrome-pediatrics (PICS-p).

With funding from UPMC Children’s Hospital of Pittsburgh Foundation and from patients’ families, CIRCLE has hired Shannon Snatchko, MSN, RN, CCRN as the CIRCLE nurse coordinator.

“The addition of Shannon and her expertise as a PICU bedside nurse was key to implementing our CIRCLE longitudinal outcomes program for children with brain injuries and their families,” said Ericka Fink, MD, MS, who is CIRCLE director and an associate professor in the Pediatric Division of the Department of Critical Care Medicine. “It’s important to realize that care for critically ill children doesn’t stop once they are well enough to leave the ICU or hospital. Recovery is dynamic and often a many, many months (or longer) journey.”

The longitudinal outcomes program was launched in fall 2021. The CIRCLE team screens children with new ABIs that may have resulted from insults such as low oxygen, stroke, or acute neurologic problems, to determine if they would benefit from CIRCLE’s personalized support. Programming includes screening for unmet recovery needs that require a referral, tracking multidomain child and family outcomes, providing a custom pediatric ICU journal, and screening and support for social determinants of health.

The CIRCLE team have partnered with colleagues in PM&R’s Acquired Brain Injury Clinic for CIRCLE follow-up. In 2022, Dr. Fink anticipates expansion to include other critically ill pediatric populations at high risk of PICS-p, establishment of virtual follow-up clinics, inclusion of interested fellows in clinic follow-ups, and research opportunities to improve outcomes.

In addition to the longitudinal outcomes program, the CIRCLE team are involved in PICU-wide initiatives such as weekly CIRCLE Rounds that encourage multidisciplinary communication and planning, and functional mobility guidelines that prevent patient debilitation.

CIRCLE’s mission is to improve child and family recovery from pediatric critical illness. The four-member CIRCLE team includes Ericka Fink, MD, MS; Sarah Rubin, MD, MsCI (CIRCLE co-director); Shannon Snatchko, MSN, RN; and Jessica Jarvis, PhD, MT-BC (CIRCLE rehabilitation scientist). For further information, see the CIRCLE webpage.