Characteristics and Outcomes of Long-Stay Patients in the Pediatric Intensive Care Unit

Kirk, Angela Hui Ping; Sng, Qian Wen; Zhang, Lu Qin; Wong, Johnson; Puthucheary, Janil; Lee, Jan Hau

doi:10.1055/s-0037-1601337

Cited by 18 publications

(10 citation statements)

References 16 publications

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“…by 84.6%, reducing the mortality rate from 2% to 0%, shortening the duration of hospitalization by 30.1%, and reducing hospitalization expenses by 42.6%. Long-stay admissions have been reported to significantly increase a patient's mortality (11), thus our results demonstrating that BAL can significantly shorten a patient's hospital stay have important clinical significance. Furthermore, BAL is simple, causes no significant side effects or complications, and avoids radiation damage; thus, it is worthy of clinical application.…”

Section: Discussionmentioning

confidence: 60%

Bronchoalveolar Lavage to Treat Neonatal Meconium Aspiration Syndrome Under Monitoring of Lung Ultrasound Based on a Prospective Case Series Study

et al. 2019

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Objectives: This study investigated the efficacy and safety of bronchoalveolar lavage (BAL) under lung ultrasound (LUS) monitoring for the treatment of meconium aspiration syndrome (MAS). Methods: A total of 120 patients were randomly divided into 2 groups: a BAL group (70 patients) and a control group (50 patients). Patients in the BAL group received an injection of lavage fluid through an endotracheal tube. After each lavage, LUS was performed to assess lung pathological changes. The control group underwent the traditional treatment. The rate of invasive and/or noninvasive ventilator use, time of ventilator use, incidence of pulmonary hypertension of the newborn (PPHN) and/or incidence of pneumothorax, duration of hospitalization of pediatric patients, hospitalization expenses and mortality were compared between the 2 groups. Results: Compared with the control group, MAS patients in the BAL group had (1) a significantly lower rate of invasive ventilator use (reduced by 57.7%, P < 0.001), (2) a significantly shortened duration of invasive ventilator treatment (reduced by 84.6%, P < 0.001), (3) a significantly reduced incidence of PPHN and/or pneumothorax (reduced by 84.6%, P < 0.001), (4) a reduced rate of mortality (from 2% to 0%), (5) a significantly shortened duration of hospitalization (reduced by 30.1%, P < 0.001), (6) significantly reduced hospitalization expenses (reduced by 42.6%, P < 0.001), and (7) stable vital signs during lavage among all patients, with no adverse effects. Conclusions: Treatment of MAS using BAL under LUS monitoring showed remarkable efficacy without adverse effects.

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Section: Discussionmentioning

confidence: 60%

Bronchoalveolar Lavage to Treat Neonatal Meconium Aspiration Syndrome Under Monitoring of Lung Ultrasound Based on a Prospective Case Series Study

et al. 2019

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“…A consequence of some children having increasingly complex medical has been some require prolonged PICU admissions. While many parents of children with critical illness experience anxiety and depression, 2 parents of children with prolonged critical illness may be at risk for greater levels of distress, 6 as prolonged admissions have higher mortality, morbidity, and complications, 17,[27][28][29] as well as presumably greater disruptions to families' routines and finances. 30 Additionally, studies show PICU clinicians commonly experience moral distress when caring for children in challenging circumstances, 10,31,32 and these emotions may be exacerbated when the child involved has a prolonged critical illness.…”

Section: Discussionmentioning

confidence: 99%

Distress and the Long-Stay Pediatric Intensive Care Unit Admission: A Longitudinal Study of Parents and the Medical Team

Salant

Gangopadhyay

Jia

et al. 2021

J Pediatr Intensive Care

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Prolonged critical illness in children has emotional consequences for both parents and providers. In this observational cohort study, we longitudinally surveyed anxiety and depression in parents and moral distress in pediatric intensive care unit (PICU) providers (attendings, fellows, and bedside registered nurses) and explored their trajectories and relationships. Anxiety/depression and provider moral distress were measured using the Hospital Anxiety and Depression Scale and the Moral Distress Thermometer, respectively. The relationships of parental and provider distress were evaluated using Spearman's correlations, and their trajectories and potentially associated variables were explored using quadratic random slope and intercept models. Predetermined associated factors included demographic and clinical factors, including parent psychosocial risk and intubation status. We found parental anxiety and depression decreased over their child's admission, and parental psychosocial risk was significantly associated with anxiety (coefficient = 4.43, p < 0.001). Clinicians in different roles had different mean levels and trajectories of moral distress, with fellows reporting greater distress early in admissions and nurses later in admissions. Parental anxiety/depression and provider distress were significantly, though moderately, correlated. We conclude that anxiety and depression in parents of children with prolonged PICU admissions and the moral distress of their clinicians correlate and vary over time and by provider role.

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“…Understanding the characteristics of LOS patients in the PICU will make it easier for PICU healthcare providers to plan for critical care services [ 26 ]. A small number of children with critical illness require long-term admission to the PICU.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the incidence, characteristics, and outcomes of pediatric chronic critical illness

Demirkıran

Kılıç²,

Tomak

et al. 2021

PLoS ONE

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Our aim was to determine characteristics of children with chronic critical illness (CCI) admitted to the pediatric intensive care unit (PICU) of a tertiary care children’s hospital in Turkey. The current study was a multicenter retrospective cohort study that was done from 2014 to 2017. It involved three university hospitals PICUs in which multiple criteria were set to identify pediatric CCIs. Pediatric patients staying in the ICU for at least 14 days and having at least one additional criterion, including prolonged mechanical ventilation, tracheostomy, sepsis, severe wound (burn) or trauma, encephalopathy, traumatic brain injury, status epilepticus, being postoperative, and neuromuscular disease, was accepted as CCI. In order to identify the newborn as a chronic critical patient, a stay in the intensive care unit for at least 30 days in addition to prematurity was required. Eight hundred eighty seven (11.14%) of the patients who were admitted to the PICU met the definition of CCI and 775 of them (87.3%) were discharged to their home. Of CCI patients, 289 (32.6%) were premature and 678 (76.4%) had prolonged mechanical ventilation. The total cost values for 2017 were statistically higher than the other years. As the length of ICU stay increased, the costs also increased. Interestingly, high incidence rates were observed for PCCI in our hospitals and these patients occupied 38.01% of the intensive care bed capacity. In conclusion, we observed that prematurity and prolonged mechanical ventilation increase the length of ICU stay, which also increased the costs. More work is needed to better understand PCCI.

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Characteristics and Outcomes of Long-Stay Patients in the Pediatric Intensive Care Unit

Cited by 18 publications

References 16 publications

Bronchoalveolar Lavage to Treat Neonatal Meconium Aspiration Syndrome Under Monitoring of Lung Ultrasound Based on a Prospective Case Series Study

Bronchoalveolar Lavage to Treat Neonatal Meconium Aspiration Syndrome Under Monitoring of Lung Ultrasound Based on a Prospective Case Series Study

Distress and the Long-Stay Pediatric Intensive Care Unit Admission: A Longitudinal Study of Parents and the Medical Team

Evaluation of the incidence, characteristics, and outcomes of pediatric chronic critical illness

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