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Improving Critical Care

Dr. Scott Watson is uncovering the ways intensive-care treatments affect children’s long-term health – and exploring new ways to help patients survive and thrive.

As a physician in Seattle Children’s Pediatric Intensive Care Unit (PICU), Dr. Scott Watson helps patients and families during some of the biggest health crises they’ll face. Most children admitted to the PICU have suffered a life-threatening injury or infection, or are struggling with cancer or another serious disease.

A PICU stay can be a harrowing experience that may include a child’s being sedated and, sometimes, put on a ventilator. While these and other treatments help save children’s lives, Watson is leading some of the first research to investigate whether they can also trigger long-term health issues.

“We know that adults who leave intensive care can experience depression and anxiety, and can struggle to get back to normal life,” Watson says. “Now we need to find out what happens to kids after they’re in the PICU. Do they go back to school, and if so, how well do they do there? Are they able to think as well as they used to? What’s their quality of life? And how can we improve it by making PICU care better?”

Studying How Sedatives Affect Children

A handful of small studies have linked common sedatives and anesthetics to neurological problems in lab animals. Some other studies have found no impact. Watson’s team is leading some of the most comprehensive studies of this issue in children.

In 2008, Watson was part of a team that received a five-year, $10 million National Institutes of Health grant to study a strategy to change how sedatives are given in the PICU. The study also investigated how the new strategy affected children’s recovery from critical illness, their long-term health and their quality of life. Watson’s team is analyzing this study’s data now.

In 2013, Watson received a five-year, $3.7 million NIH grant to co-lead a study that looks at how sedatives affect children’s memory, language skills, overall IQ and other key neurological functions.

“It’s one of the largest prospective studies ever to look at the long-term effects of sedation in children,” Watson says. “It will get us closer to understanding if sedatives have lasting impacts and will better position us to explore alternatives.”

Building a Comprehensive Research Program

Watson and his Seattle Children’s colleagues are also developing one of the first programs to study pediatric critical care’s long-term effects on children’s health and their families. The team’s first step is to start surveying high-risk patients who leave the PICU about their quality of life, emotional health and family recovery over the first year after leaving the hospital.

Over time, the new program will become a hub for studies that seek to determine what puts children in the PICU at risk of lasting health problems. This will set the stage for developing ways to prevent those problems.

“One aspect of working in the PICU is that we see patients during these intense periods and then we usually never see them again,” Watson says. “The new program will help us stay in touch, so we can understand the effects of what we do and improve critical care where we need to.”