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Published on: April 7, 2023
Intensive care for infants and children in Haiti in April 2010
Amélie von Saint André-von Arnim1, Thomas V Brogan, Jeremy Hertzig
1Department of Pediatric Critical Care Medicine, Seattle Children's Hospital, Seattle, WA, USA.
Insights
Pediatric critical care was provided in Haiti post-earthquake, highlighting the need for careful resource allocation. Survivors had acute, reversible conditions, emphasizing the importance of patient selection in low-resource settings.
Area of Science:
- Disaster medicine
- Pediatric critical care
- Global health
Background:
- A major earthquake devastated Haiti, creating an urgent need for medical services.
- Critical care for infants and children is essential but challenging in resource-limited environments.
Purpose of the Study:
- To document the experience of delivering pediatric critical care in Haiti.
- To analyze patient demographics, conditions, and outcomes in a post-disaster setting.
Main Methods:
- Observational study of a field medical facility.
- Combined neonatal and pediatric intensive care unit (ICU) admission data collected over one week.
- Analysis of patient characteristics and reasons for ICU admission.
Main Results:
- 29 patients (9 infants, 20 children) were admitted to an ICU with limited capacity.
- Central nervous system and infectious diseases were primary admission diagnoses.
- Mortality rate was 45% among admitted children; survivors had acute, reversible illnesses.
Conclusions:
- Pediatric critical care is feasible in low-income countries but resource-intensive.
- Careful patient selection is crucial for effective resource utilization.
- The cost-effectiveness of critical care in developing nations requires careful consideration to avoid diverting resources from broader public health initiatives.
Objective:
To describe a unique experience providing critical care to infants and children in Haiti 3 months after a major earthquake.
Design:
Observational.
Setting:
Field medical facility in a developing country.
Patients:
Infants and children admitted to a combined neonatal and pediatric intensive care unit between April 17 and 24, 2010.
Interventions:
None.
Measurements And Main Results:
Nine infants and 20 children were admitted to an intensive care unit with eight cots and ten infant beds over a 1-wk period. Central nervous system and infectious diseases were the most common reasons for intensive care unit admission. Nine of 20 (45%) children died before hospital discharge. Survivors represented a cohort of children with acute, reversible disease.
Conclusions:
Pediatric critical care can be implemented in low-income countries but requires significant resource use and careful patient selection. Consideration should be paid to the costs of delivering critical care in developing countries, which can inadvertently appropriate resources that have a larger impact on pediatric public health.
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