Abstract P-393: ABILITY TO ASSENT IN PEDIATRIC CRITICAL CARE RESEARCH: A PROSPECTIVE ENVIRONMENTAL SCAN OF TWO CANADIAN PICUS

Aims & Objectives: To determine the number of patients considered not appropriate to approach for assent by the research and healthcare teams within the first 24 hours of pediatric intensive care unit (PICU) admission. Methods Prospective one-month environmental scan of 2 Canadian academic PICUs. Ninety critically ill children age newborn to 17 years were categorized as appropriate or not appropriate to approach for assent using a standardized assessment (Figure 1) daily for the first 7 days of PICU admission and at PICU discharge. Results At PICU admission, 81% of patients were deemed not appropriate to approach for assent, mostly due to age limitations, influence of psychotropic medications and/or mechanical ventilation (Table 1). Patients considered appropriate to approach on admission generally spent a short (<24 to 48 hours) time in PICU (Figure 2). At PICU discharge, 74% of patients were considered not appropriate to approach, most commonly due to age limitations, developmental delay, mechanical ventilation and/or influence of psychotropic medication. Only 8% of patients considered not approachable at admission become appropriate to approach for assent by PICU discharge. There was good and moderate agreement between study team and care team assessments of potential for assent at admission and discharge respectively. Conclusions Very few patients were considered appropriate to approach for assent during the first 24 hours of PICU admission or by PICU discharge. Those that were considered appropriate to approach were less ill, spent less time in PICU, and were unlikely to be considered for enrolment in pediatric critical care research.

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