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Unplanned anesthesia-related admissions to pediatric intensive care - a 6-year audit
1Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, WA, Australia.
Insights
Unplanned pediatric intensive care unit admissions after anesthesia are rare, affecting 0.14% of procedures. Most cases involved airway issues in young children and were potentially predictable.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
Background:
- Unplanned intensive care unit admissions are a clinical indicator for anesthesia-related events.
- Adult anesthesia-related unplanned admission rates range from 0.04% to 0.45% of procedures.
- Data on pediatric anesthesia-related unplanned admissions are limited.
Purpose of the Study:
- To determine the rate of unplanned admissions to the pediatric intensive care unit (PICU) within 24 hours of anesthesia.
- To identify the causes and management of these unplanned admissions in children.
Main Methods:
- Retrospective chart review of pediatric intensive care unit admissions within 24 hours of anesthesia.
- Inclusion criteria focused on anesthesia complications, excluding communication or surgical issues.
Main Results:
- The rate of unplanned admission was 0.14% (76 out of 55,196 procedures) over a 6-year period.
- Airway problems accounted for 47% of admissions; 68% of admitted children were under 5 years old.
- Most children required only observation post-admission.
Conclusions:
- The rate of unplanned pediatric intensive care unit admissions is similar to adult rates and is rare.
- Airway issues in children under 5 years old were the primary cause of admission.
- Many of these anesthesia-related unplanned admissions were potentially predictable.
Background:
Unplanned admissions to the intensive care unit may result from unexpected events related to anesthesia, and are recommended by some healthcare organizations as a clinical indicator. The rate of anesthesia-related unplanned admissions in adults ranges between 0.04% and 0.45% of procedures. However, there is a paucity of data relating to the rate in children.
Methods:
Admissions to the pediatric intensive care unit (PICU) occurring within 24 h of anesthesia were identified through retrospective chart review. Only those admissions from a complication of anesthesia were included and not those from communication errors or surgical problems. The aim was to determine the rate of unplanned admissions, as well as the causes and management of this group of unplanned admissions.
Results:
Seventy-six children requiring admission to the PICU were identified from 55196 procedures during the 6-year study period. The rate of unplanned admission was 0.14% of procedures. A total of 47% of these admissions were related to airway problems and 68% of children requiring admission were aged less than 5 years. Most children required only observation after their admission.
Conclusions:
We found the unplanned admission rate to the PICU in our hospital population to be similar to that reported for adults, and is a relatively rare event in pediatric anesthesia. Most admissions were for children aged less than 5 years and were as a result of airway problems. Most cases were deemed potentially predictable.
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