Publication Q&A: Association of Acute Respiratory Failure in Early Childhood With Long-Term Neurocognitive Outcomes

March 2022 – In this Q&A, R. Scott Watson shares insights from a recent publication in the Journal of the American Medical Association.

R. Scott Watson, MD, MPH

Published in the Journal of the American Medical Association, March 2022

Read article in the Journal of the American Medical Association

Read editorial in the Journal of the American Medical Association

What are the significant findings in this paper?

We studied a group of children without known neurologic problems treated in an intensive care unit for lung failure.  The treatment helped their breathing with a machine and small tube in the mouth or nose that went to the windpipe.  Three to eight years after leaving the hospital, the children had a lower IQ than their siblings.  The differences were greatest in the youngest children (in the hospital when less than 1 year old).  On average, the differences were small, but more than twice as many treated children had a much lower IQ than their siblings.

What does this research tell us that we didn’t know before?

Children without known neurologic problems who require treatment in an intensive care unit for severe lung failure are at risk of long-term cognitive problems, especially those hospitalized at a young age. 

What are the broad implications of this research? (i.e., How might this research lead to better ways to treat/prevent/diagnose?)

Children recovering from lung failure managed with a breathing machine and tube in the windpipe may benefit from testing of cognitive function after hospital discharge.  They may require several tests over time to identify problems that show up over the course of the child’s development.  The goal of the testing it to identify problems that can be helped by early intervention, to prevent disability, and to improve school performance.

What are the next steps and long-term goals for this research?

We are looking into whether there are specific aspects of a child's illness or the care that they receive that increase the risk of problems in hopes that we can prevent future problems and identify them as early as possible so that they may be treated most effectively.

Any other specific information should we know about this paper?

Although it is concerning that some children have difficulties, fortunately most do not.