Ability to Assent in Pediatric Critical Care Research: A Prospective Environmental Scan of Two Canadian PICUs

Objectives: To determine the number of patients considered not appropriate to approach for assent within the first 24 hours of PICU admission. Design: Exploratory prospective 1-month environmental scan. Setting: Two tertiary Canadian PICUs. Patients: Ninety patients age newborn to 17 years old admitted to the PICU during September 2016 (Site 1) or May 2017 (Site 2). Interventions: None. Measurements and Main Results: At PICU admission, 81% of patients were deemed not appropriate to approach for assent most commonly due to age, influence of psychotropic medications, and/or mechanical ventilation. At PICU discharge, 74% of patients were considered not appropriate to approach, most commonly due to age and/or developmental delay. There was moderate to good agreement between the research team and care team assessments of appropriateness for assent. Only 8% of patients considered not approachable at admission become appropriate to approach for assent by PICU discharge. Conclusions: Very few patients were considered approachable for assent during the first 24 hours of PICU admission. Those who were considered appropriate to approach were less ill, spent less time in PICU, and were unlikely to be considered for enrollment in pediatric critical care research. This work was performed at Children’s Hospital of Eastern Ontario, Alberta Children’s Hospital, Calgary, AB, Canada. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (https://ift.tt/2gIrZ5Y). Supported, in part, by Canadian Critical Care Research Coordinator Grant. Ms. Martin received funding from Children’s Hospital of Eastern Ontario. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: dmcnally@cheo.on.ca ©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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