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Pediatric Intensive Care Unit Admission and Outcomes in Trisomy 21 Patients: A Retrospective Analysis

Demet Tosun1, Batuhan Türkoğlu1, İlyas Bingöl1

  • 1Department of Pediatric Intensive Care Unit, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Clinical Pediatrics
|November 27, 2025
PubMed

Insights

Children with Down syndrome (T21) often need intensive care. Respiratory failure is the main reason for PICU admission, and mortality is linked to ventilation, inotropic support, and organ dysfunction.

Area of Science:

  • Pediatric Critical Care Medicine
  • Genetics
  • Neonatology

Background:

  • Children with Trisomy 21 (Down syndrome, T21) have frequent comorbidities necessitating intensive care.
  • Understanding PICU admission reasons and mortality factors in T21 is crucial for improving outcomes.

Purpose of the Study:

  • To evaluate the primary reasons for Pediatric Intensive Care Unit (PICU) admission in children with T21.
  • To identify clinical features and mortality factors associated with T21 patients in the PICU.

Main Methods:

  • Retrospective study of genetically confirmed T21 patients admitted to the PICU between January 2023 and December 2024.
  • Analysis of demographic data, clinical features, laboratory results, and outcomes.

Main Results:

  • Respiratory failure was the leading cause for PICU admission (81%) in 37 T21 patients.
  • The overall mortality rate was 13.5%. Nonsurvivors required invasive mechanical ventilation and inotropic support, and showed higher rates of tachycardia, arrhythmia, hypotension, renal dysfunction, and electrolyte disturbances.
  • Elevated procalcitonin and lactate dehydrogenase (LDH) levels were observed in nonsurvivors.

Conclusions:

  • Respiratory failure is the primary indication for PICU admission in children with T21.
  • Mortality in this population is associated with the need for mechanical ventilation, inotropic support, and the presence of renal and electrolyte disturbances.
  • Further multicenter, prospective studies are recommended to enhance generalizability and understanding of T21 critical care needs.

Keywords:
Down syndromepediatric intensive care unitrespiratory failure

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