Sinha, R, Aramburo, A, Deep, A et al. (13 more authors) (2021) Caring for critically ill adults in paediatric intensive care units in England during the COVID-19 pandemic: planning, implementation and lessons for the future. Archives of Disease in Childhood, 106 (6). pp. 548-557. ISSN 0003-9888
Abstract
Objective
To describe the experience of paediatric intensive care units (PICUs) in England that repurposed their units, equipment and staff to care for critically ill adults during the first wave of the COVID-19 pandemic.
Design
Descriptive study.
Setting
Seven PICUs in England.
Main outcome measures
(1) Modelling using historical Paediatric Intensive Care Audit Network data; (2) space, staff, equipment, clinical care, communication and governance considerations during repurposing of PICUs; (3) characteristics, interventions and outcomes of adults cared for in repurposed PICUs.
Results
Seven English PICUs, accounting for 137 beds, repurposed their space, staff and equipment to admit critically ill adults. Neighbouring PICUs increased their bed capacity to maintain overall bed numbers for children, which was informed by historical data modelling (median 280–307 PICU beds were required in England from March to June). A total of 145 adult patients (median age 50–62 years) were cared for in repurposed PICUs (1553 bed-days). The vast majority of patients had COVID-19 (109/145, 75%); the majority required invasive ventilation (91/109, 85%). Nearly, a third of patients (42/145, 29%) underwent a tracheostomy. Renal replacement therapy was provided in 20/145 (14%) patients. Twenty adults died in PICU (14%).
Conclusion
In a rapid and unprecedented effort during the first wave of the COVID-19 pandemic, seven PICUs in England were repurposed to care for adult patients. The success of this effort was underpinned by extensive local preparation, close collaboration with adult intensivists and careful national planning to safeguard paediatric critical care capacity.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. This is an author produced version of an article, published in Archives of Disease in Childhood. Uploaded in accordance with the publisher's self-archiving policy. This manuscript version is made available under the CC BY-NC 4.0 license https://creativecommons.org/licenses/by-nc/4.0/ |
Keywords: | epidemiology; microbiology |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Funding Information: | Funder Grant number Healthcare Quality Improvement HQIP NCA 2009 |
Depositing User: | Symplectic Publications |
Date Deposited: | 04 Feb 2021 14:07 |
Last Modified: | 20 Jul 2021 03:41 |
Status: | Published |
Publisher: | BMJ Publishing Group |
Identification Number: | 10.1136/archdischild-2020-320962 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:170670 |