1. Assessing the predictors for paediatric intensive care unit for inter-hospital transfer patients on high-flow nasal cannula or continuous positive airway pressure ventilation at a tertiary Australian paediatric hospital.
- Author
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Astle V, Borland ML, Betts K, Erickson S, and Gowen B
- Subjects
- Humans, Male, Female, Retrospective Studies, Infant, Child, Preschool, Child, Australia, Oxygen Inhalation Therapy methods, Oxygen Inhalation Therapy statistics & numerical data, Intensive Care Units, Pediatric statistics & numerical data, Continuous Positive Airway Pressure methods, Continuous Positive Airway Pressure statistics & numerical data, Continuous Positive Airway Pressure instrumentation, Patient Transfer methods, Patient Transfer statistics & numerical data, Cannula, Tertiary Care Centers organization & administration, Tertiary Care Centers statistics & numerical data, Hospitals, Pediatric statistics & numerical data
- Abstract
Objective: The aim of the present study was to assess the predictors of need for paediatric intensive care unit (PICU) admission for inter-hospital transfer patients to a tertiary paediatric hospital ED on high flow (HF) or continuous positive airway pressure (CPAP) ventilation., Methods: Single-centre retrospective study of patients transferred to the state's tertiary paediatric hospital. Demographic information and disease management information was obtained., Results: Between October 2021 and September 2022, 53 patients were transferred to the tertiary hospital on HF or CPAP. Of these, 23 required admission to PICU. Those admitted to PICU had a higher median fraction of inspired oxygen than those not admitted (0.4 vs 0.3, respectively, P = 0.013). Patients transported by road (vs flight) were more likely (20/23 patients, RR = 3.15, P = 0.016) to be admitted to PICU (56% vs 18%). Those who had received CPAP prior to or during transfer were more likely to require PICU admission (P = 0.012)., Conclusion: We have demonstrated that children who require CPAP to manage their respiratory disease are more likely to require PICU care on transfer to the tertiary paediatric hospital. In addition, those patients being transferred from secondary metropolitan hospitals after a trial of HF are also likely to require PICU care. This suggests that these patients should be directly admitted to PICU, allowing for improved patient experience and flow as well as reducing unnecessary ED resource utilisation., (© 2024 Australasian College for Emergency Medicine.)
- Published
- 2024
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