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The Impact of Dedicated Cardiac Intensive Care Units on Outcomes in Pediatric Cardiac Surgery: A Virtual Pediatric

Dayanand N Bagdure1, Jason W Custer1, Cortney B Foster1

  • 1Department of Pediatrics, Division of Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States.

Journal of Pediatric Intensive Care
|August 16, 2021
PubMed

Insights

Pediatric cardiac intensive care units (CICU) and mixed intensive care units show similar outcomes for children undergoing cardiac surgery. Risk category, not unit type, correlates with mortality rates.

Area of Science:

  • Pediatric Cardiac Surgery
  • Intensive Care Medicine
  • Healthcare Management

Background:

  • Children undergoing cardiac surgery require specialized intensive care.
  • Care is provided in either dedicated cardiac intensive care units (CICU) or mixed intensive care units.

Purpose of the Study:

  • To compare patient outcomes and mortality rates between dedicated CICUs and mixed intensive care units for pediatric cardiac surgery patients.
  • To analyze the impact of the Society of Thoracic Surgery-European Association of Cardiothoracic Surgery (STS-EACTS) risk categories on outcomes in different unit types.

Main Methods:

  • Analysis of the Virtual Pediatric Systems (VPS) database from 2009-2014.
  • Inclusion of pediatric patients (<18 years) undergoing cardiac surgery.
  • Classification of patients based on STS-EACTS risk categories and comparison of mortality rates between dedicated CICUs and mixed units.

Main Results:

  • A total of 47,814 patients were analyzed (22,762 in CICUs, 25,052 in mixed units).
  • Mortality rates were 2.62% in CICUs and 2.99% in mixed units.
  • No significant difference in mortality was found between unit types when adjusted for STS-EACTS risk categories.

Conclusions:

  • Unit type (dedicated CICU vs. mixed unit) does not significantly impact mortality outcomes for pediatric cardiac surgery patients.
  • Patient outcomes are primarily influenced by the STS-EACTS risk category, irrespective of the intensive care unit setting.

Keywords:
cardiac surgeryoutcomespediatrics

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