Priorities for paediatric critical care research: a modified Delphi study by the Australian and New Zealand Intensive Care Society Paediatric Study Group

Sainath Raman; Georgia Brown; Debbie Long; Ben Gelbart; Carmel Delzoppo; Johnny Millar; Simon Erickson; Marino Festa; Luregn J Schlapbach; Australian and New Zealand Intensive Care Society Paediatric Study Group (ANZICS PSG)

doi:10.51893/2021.2.oa6

Priorities for paediatric critical care research: a modified Delphi study by the Australian and New Zealand Intensive Care Society Paediatric Study Group

Crit Care Resusc. 2023 Oct 18;23(2):194-201. doi: 10.51893/2021.2.oa6. eCollection 2021 Jun.

Authors

Sainath Raman^{1

2}, Georgia Brown^{3

4}, Debbie Long^{1

2

5}, Ben Gelbart^{3

4}, Carmel Delzoppo^{3

4}, Johnny Millar^{3

4}, Simon Erickson⁶, Marino Festa^{7

8}, Luregn J Schlapbach^{1

2

9}; Australian and New Zealand Intensive Care Society Paediatric Study Group (ANZICS PSG)

Affiliations

¹ Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia.
² Paediatric Intensive Care Unit, Queensland, Children's, Hospital, Brisbane, QLD, Australia.
³ University of Melbourne, Melbourne, VIC, Australia.
⁴ Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia.
⁵ School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia.
⁶ Paediatric Intensive Care Unit, Perth Children's Hospital, Perth, WA, Australia.
⁷ Paediatric Intensive Care Unit, Children's Hospital Westmead, Sydney, NSW, Australia.
⁸ Kids Critical Care Research Group, Kids Research, Sydney Children's Hospitals Network, Sydney, NSW, Australia.
⁹ Pediatric and Neonatal Intensive Care Unit, University Children's Hospital Zurich, and Children's Research Center, University of Zurich, Zurich, Switzerland.

Abstract

Objective: Most interventions in paediatric critical care lack high grade evidence. We aimed to identify the key research priorities and key clinical outcome measures pertinent to research in paediatric intensive care patients. Design: Modified three-stage Delphi study combining staged online surveys, followed by a face-to-face discussion and final voting. Setting: Paediatric intensive care units in Australia and New Zealand. Participants: Medical and nursing staff working in intensive care. Main outcome measurements: Self-reported priorities for research. Results: 193 respondents provided a total of 267 research questions and 234 outcomes. In Stage 3, the top 56 research questions and 50 outcomes were discussed face to face, which allowed the identification of the top 20 research questions with the Hanlon prioritisation score and the top 20 outcomes. Topics centred on the use of intravenous fluids (restrictive v liberal fluids, use of fluid resuscitation bolus, early inotrope use, type of intravenous fluid, and assessment of fluid responsiveness), and patient- and family-centred outcomes (health-related quality of life, liberation) emerged as priorities. While mortality, length of stay, and organ support/organ dysfunction were considered important and the most feasible outcomes, long term quality of life and neurodevelopmental measures were rated highly in terms of their importance. Conclusions: Using a modified Delphi method, this study provides guidance towards prioritisation of research topics in paediatric critical care in Australia and New Zealand, and identifies study outcomes of key relevance to clinicians and experts in the field.