Related Experiment Video
Updated: Dec 5, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
The Changing Landscape in Pediatric Hospitals: A Multicenter Study of How Pediatric Chronic Critical Illness Impacts
Renee D Boss1,2, Carrie M Henderson3,4, Elliott M Weiss5,6
1Division of Neonatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Infants with chronic critical illness represent 35% of complex pediatric inpatients, often requiring intensive care and medical technology. Understanding their needs is crucial for effective hospital resource planning and bed management.
Area of Science:
- Pediatric critical care medicine
- Healthcare resource management
- Medical technology utilization in pediatrics
Background:
- Prolonged hospitalizations of children with medical complexity strain pediatric inpatient bed availability.
- Infants with chronic critical illness (CCI) are a significant but poorly characterized patient group.
- Accurate data on CCI infants is essential for effective resource allocation in intensive care units (ICUs) and general pediatric wards.
Purpose of the Study:
- To describe the characteristics of infants with chronic critical illness.
- To analyze hospitalization patterns and medical technology use in this population.
- To inform resource planning for pediatric healthcare systems.
Main Methods:
- Screening of infants admitted to six US academic medical centers.
- Inclusion criteria based on prolonged/repeated hospitalizations, medical technology use, and multiorgan involvement.
- Collection of patient and hospitalization data.
Main Results:
- Infants (<12 months) constituted 34.8% of eligible chronic critical illness inpatients.
- Nearly all infants used medical technology (97.8%) and had multiorgan involvement (94.8%).
- Eighty-six percent spent time in an ICU; 78.2% were discharged with medical technology, often escalated upon readmission.
Conclusions:
- Advanced strategies are needed for hospital resource allocation for infants with CCI.
- These infants' care often transitions between neonatal ICUs, other ICUs, and general wards.
- Early identification and tracking, starting in the neonatal ICU, are vital for anticipating and managing inpatient bed needs.
Objective:
Pediatric inpatient bed availability is increasingly constrained by the prolonged hospitalizations of children with medical complexity. The sickest of these patients are chronic critically ill and often have protracted intensive care unit (ICU) stays. Numbers and characteristics of infants with chronic critical illness are unclear, which undermines resource planning in ICU's and general pediatric wards. The goal of this study was to describe infants with chronic critical illness at six academic institutions in the United States.
Study Design:
Infants admitted to six academic medical centers were screened for chronic, critical illness based on a combination of prolonged and repeated hospitalizations, use of medical technology, and chronic multiorgan involvement. Data regarding patient and hospitalization characteristics were collected.
Results:
Just over one-third (34.8%) of pediatric inpatients across the six centers who met eligibility criteria for chronic critical illness were <12 months of age. Almost all these infants received medical technology (97.8%) and had multiorgan involvement (94.8%). Eighty-six percent (115/134) had spent time in an ICU during the current hospitalization; 31% were currently in a neonatal ICU, 34% in a pediatric ICU, and 17% in a cardiac ICU. Among infants who had been previously discharged home (n = 55), most had been discharged with medical technology (78.2%) and nearly all were still using that technology during the current readmission. Additional technologies were commonly added during the current hospitalization.
Conclusion:
Advanced strategies are needed to plan for hospital resource allocation for infants with chronic critical illness. These infants' prolonged hospitalizations begin in the neonatal ICU but often transition to other ICUs and general inpatient wards. They are commonly discharged with medical technology which is rarely weaned but often escalated during subsequent hospitalizations. Identification and tracking of these infants, beginning in the neonatal ICU, will help hospitals anticipate and strategize for inpatient bed management.
Key Points:
· 35% of inpatients with chronic critical illness are infants.. · Nearly 90% of these infants spend some time in an intensive care unit.. · 78% are discharged with medical technology..
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
11:27A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care