Outcome of Adolescent Trauma Admitted to an Adult Surgical Intensive Care Unit versus a Pediatric Intensive Care Unit

Sánchez, Javier; Lucas, Jon; Feustel, Paul J.

doi:10.1097/00005373-200109000-00009

Cited by 12 publications

(7 citation statements)

References 7 publications

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“…Coresidence may influence the quality and intensity of care for children, as indicated in a prior study that showed shorter severity-adjusted lengths of stay and fewer days of mechanical ventilation for adolescent trauma victims admitted to a PICU, compared with an adult surgical ICU. 19 Although the number of coresident PICUs is small now, the phenomenon of coresidence warrants additional investigation, because constrained fiscal or staffing resources may force some smaller facilities that have separate PICU beds currently to consider coresidence in the future.…”

Section: Discussionmentioning

confidence: 99%

A National Survey of Pediatric Critical Care Resources in the United States

Odetola¹,

Clark²,

Freed³

et al. 2005

Pediatrics

113

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A recently published analysis of pediatric critical care resources through 2001 found that the number of PICU beds in the United States has increased since 1995, beyond what would be expected on the basis of population growth. 2 A concurrent study of data based on the annual American Hospital Association (AHA) survey illustrated that PICU facilities were available in only 9% of US counties, predominantly in urban areas. 3 Uneven distribution of PICU resources despite an apparent increase in the overall supply over time raises questions about access to timely appropriate care for critically ill and injured children.To facilitate characterization of US PICUs, 2 levels of PICU care have been defined. Critically ill children who require services not available or infrequently used in level II PICUs are referred to level I PICUs, with higher levels of subspecialist and technologic support. 4 Delineation of the available resources for the care of critically ill and injured children is a first step in evaluating the adequacy and efficiency of PICU care. This study was conducted to describe the availability and characteristics of facilities for critically ill and injured children across the United States in 2004.

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Section: Discussionmentioning

confidence: 99%

A National Survey of Pediatric Critical Care Resources in the United States

Odetola¹,

Clark²,

Freed³

et al. 2005

Pediatrics

113

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“…This might be attributable to several causes, including the expertise of medical staff treating critically ill children. According to prior studies, a lack of specialist medical staff in PICU increases the number and duration of treatments such as mechanical ventilation, central catheterization, and urinary catheterization, leading to an increase in hospital‐acquired infections . In this study, all patients were cared for by a pediatrician.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Acinetobacter baumannii infection in children in adult versus pediatric intensive care units

Kim

Yoon

2020

Pediatrics International

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Background: We hypothesized that children treated in adult intensive care units (ICUs) might be at increased risk of hospital-acquired infection. We therefore compared the incidence of Acinetobacter baumannii infection in children treated in pediatric ICUs (PICUs) and in those treated in adult ICUs. Methods: Patients aged <18 years admitted to PICUs or adult ICUs between March 2009 and June 2017 were enrolled. We retrospectively investigated A. baumannii isolates and calculated the A. baumannii incidence during ICU admission. Cox regression was used to identify possible risk factors for A. baumannii infection. Results: Eight hundred and thirty ICU cases were included; 508 were treated in PICUs ("PICU group") and 322 in adult ICUs ("adult-ICU group"). Acinetobacter baumannii was isolated 19 (3.7%) and 23 (7.1%) times in the PICU and adult-ICU groups, respectively. Incidence densities for A. baumannii acquisition in PICU and adult-ICU groups were 1.63 and 5.62 per 1,000 ICU days, respectively. In the Cox regression model, the hazard ratio for A. baumannii acquisition associated with treatment in PICUs was 0.33 (95% confidence interval: 0.17-0.61; P = 0.001). In multivariate analysis after adjusting for age and sex, treatment in PICU remained significantly associated with a reduced risk of A. baumannii infection (hazard ratio: 0.40; 95%; confidence interval: 0.20-0.76). Conclusions: Pediatric patients treated in a PICU had a lower rate and incidence density of A. baumannii nosocomial infection than those treated in adult ICUs, suggesting that PICUs provide better infection control for children than adult ICUs.

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“…This principle also applies to a child with major injuries. Reports from the USA indicate that a tiered system of management improves outcome 12,16 and the London Severe Injuries Group proposed a three-tier triage system for trauma services in London, which draws attention to the need for triage guidelines (H. Phillips, personal communication)…”

Section: Discussionmentioning

confidence: 99%

“…For less severely injured children, other factors are taken into consideration, including the mechanism and severity of injury, the nature of the injuries and the age of the child. The services and facilities available at each hospital are also relevant 11,16 .…”

Section: Discussionmentioning

confidence: 99%

Development, implementation and prospective evaluation of guidelines for transfer of severely injured children to specialist centres

Patterson

Jones

2006

British Journal of Surgery

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Outcome of Adolescent Trauma Admitted to an Adult Surgical Intensive Care Unit versus a Pediatric Intensive Care Unit

Abstract: Adolescent trauma patients admitted to the PICU were less likely to be intubated or have a Swan-Ganz catheter placed. They had decreased LOS and days of mechanical ventilation. There was no difference in outcome measurements.

Cited by 12 publications

References 7 publications

A National Survey of Pediatric Critical Care Resources in the United States

A National Survey of Pediatric Critical Care Resources in the United States

Nosocomial Acinetobacter baumannii infection in children in adult versus pediatric intensive care units

Development, implementation and prospective evaluation of guidelines for transfer of severely injured children to specialist centres

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