Multisystem Inflammatory Syndrome in Children in the Critical Care Setting.

Atlas, Kristin; Farber, Jessica Strohm; Shields, Kerry; Lebet, Ruth

BACKGROUND Multisystem inflammatory syndrome in children is a new syndrome that has been hypothesized to be connected with the COVID-19 pandemic. Children are presenting-likely after SARS-CoV-2 infection or exposure-with vague symptoms including fever, gastrointestinal distress, and/or rash. OBJECTIVE To review what is currently known about multisystem inflammatory syndrome in children, including physiology, signs and symptoms, laboratory and imaging findings, treatment options, and nursing considerations in critical care settings. METHODS This integrative review was conducted using the keywords multisystem inflammatory syndrome in children, Kawasaki-like syndrome, COVID, COVID-19, and SARS-CoV-2. Initially, 324 articles were found. All were screened, and 34 were included. Eight articles were added after hand-searching and weekly literature searches were conducted. DATA SYNTHESIS Multisystem inflammatory syndrome in children is a newly identified syndrome, thus information on diagnosis, treatment, and outcomes is available but evolving. Many aspects of nursing care are important to consider with regard to this illness, including COVID precautions, physical assessments, medication administration, and timing of blood sampling for laboratory testing as well as other standard intensive care unit considerations. Providing anticipatory guidance and support to patients and their families is also important. CONCLUSION Critical care nurses must remain informed about advances in the care of patients with multisystem inflammatory syndrome in children, as these patients are often seen in critical care environments because of their high risk of cardiovascular failure.