Related Experiment Video
Updated: Aug 23, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Congenital neurodevelopmental diagnoses and an intensive care unit: defining a population
Robert J Graham1, Helene M Dumas, Jane E O'Brien
1Division of Critical Care, Department of Anesthesia, Children's Hospital Boston, Boston, MA, USA.
Insights
Children with neurodevelopmental disorders represent nearly a quarter of pediatric intensive care unit admissions, requiring significant resources. Their ongoing medical needs highlight the growing impact of this population on critical care services.
Area of Science:
- Pediatric Critical Care Medicine
- Neurodevelopmental Pediatrics
- Healthcare Resource Utilization
Background:
- Children with congenital or perinatal neurodevelopmental diagnoses are increasingly admitted to pediatric intensive care units (PICUs).
- Understanding their resource utilization is crucial for effective healthcare planning and delivery.
Purpose of the Study:
- To identify and describe the population of children with neurodevelopmental diagnoses in a PICU.
- To assess their critical care resource utilization patterns.
Main Methods:
- A 12-month inception cohort study was conducted at an urban, tertiary care pediatric hospital.
- Admissions were screened for pre-existing neurodevelopmental diagnoses, with data extracted from medical records.
Main Results:
- Congenital neurodevelopmental diagnoses accounted for 23% of PICU admissions (427/1820), with Trisomy 21 being common.
- Over half of these admissions (52%) involved technology dependence, and many were scheduled surgical cases or for respiratory illness management.
- Despite requiring ventilatory support, length of stay and mortality rates were comparable to general PICU populations, though technology support needs increased at discharge.
Conclusions:
- Children with neurodevelopmental diagnoses constitute a significant and growing proportion of PICU admissions.
- This population has substantial ongoing medical needs, impacting critical care resource allocation.
- Further research is needed to optimize care for these children and support their families.
Objective:
To identify and describe the population of children with congenital or perinatally acquired neurodevelopmental diagnoses in a pediatric intensive care unit and to assess the nature and extent of their utilization of critical care resources.
Design:
Twelve-month, inception cohort study.
Setting:
Intensive care unit at an urban, tertiary care pediatric hospital.
Patients And Methods:
All pediatric intensive care unit admissions were screened for preexisting neurodevelopmental diagnoses. Computerized and chart-based medical records were reviewed for demographic, clinical, and outcome data.
Results:
A total of 309 children with congenital neurodevelopmental diagnoses accounted for 427 pediatric intensive care unit admissions. This represented 23% of the total 1,820 admissions in 1 yr. Trisomy 21 was the most identifiable developmental abnormality (n = 25, 8%). Eighty-five percent of the children were cared for at home before hospitalization. A total of 220 of the admissions (52%) demonstrated a preexisting technology dependence. Fewer children admitted from the home-care setting had tracheostomies or were ventilator dependent. The majority of admissions were scheduled surgical admissions (45%) or for management of acute respiratory illness (26%). Of the patients with preexisting tracheostomy, nonrespiratory conditions accounted for 70% of acute admitting diagnoses. Two hundred twenty-three of the admissions (52%) required noninvasive or transtracheal ventilatory support, yet the length of stay and mortality rate were consistent with those reported in other general pediatric intensive care unit populations. The average and median length of stay were 5.4 and 2.0 days, respectively. Mortality rate was 3%. Technology support needs at discharge increased significantly from admission for enterostomy support (p =.008) and mechanical ventilation (p =.008).
Conclusions:
Children with congenital or perinatally acquired neurodevelopmental diagnoses represented nearly one quarter of all pediatric intensive care unit admissions at a tertiary academic center. This population has substantial ongoing medical needs, requiring utilization of intensive care resources. More rigorous investigations are needed to determine the effect of this burgeoning population in pediatric critical care, to optimize their care, and to meet the comprehensive needs of their families.
Related Concept Videos
01:29Intellectual Disability
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:26Formulating and Validating Nursing Diagnosis I
There are thirteen domains for...
01:25Formulating and Validating Nursing Diagnosis II
Risk nursing diagnoses represent clinical judgments of an individual, family, or community more vulnerable to developing the health problem than others...
01:19Restorative Care