Children continue to be admitted to adult ICUs for care, although this number is dropping, the latest audit of paediatric critical care shows.
The Irish Paediatric Critical Care Audit’s national report for 2020 also shows 82 children admitted to the two children’s intensive care units (ICU) with Covid-19 between March 2020 and July 2022.
No deaths were linked to this virus among this group of children in that time, the audit states.
There are two intensive care units for children in Ireland, both in Dublin, in Crumlin and Temple Street.
Children from other areas are transferred for care — 31% of patients in the Crumlin unit came from other hospitals and 62% of those in Temple Street’s unit.
Among the 68 children treated in adult units during 2020, some 40% were in Galway and 16% in Cork. This is a decrease from 111 in 2019.
Almost one-in-three (31%) were under six years of age, 31% had to be ventilated and the median length of stay was 38.5 hours.
Among five recommendations made in the audit is that children being treated in an adult ICU should be discussed with the National Paediatric Critical Care Network.
Clinical lead of the Irish Paediatric Critical Care Audit Professor Martina Healy also called for support for more data collection, including on subspecialty classification of rare diagnoses.
Further data on Covid-19 between March 2020 and last July shows 41 admissions with a diagnosis of PIMS-TS (paediatric inflammatory multisystem syndrome). This is thought to be an autoinflammatory response to Covid-19 and was first identified in April 2020, the audit states.
The audit notes since the Omicron variant became dominant, there was “a fall-off in PIMS-TS admissions during the period October 2021 to July 2022”.
It states: “… reduction in PIMS-TS may also be influenced by the rollout of the SARS-CoV-2 vaccine in the ROI to children aged under 12 years”.
Children with Covid-19 had a median length of stay of three days. Some 40% of young Covid patients needed ventilation help.
Overall, the number of admissions to these two units in 2020 (including children aged 16 or over) was 1,399, a decrease of 9% from 2019.
The unit at CHI in Crumlin was the third busiest of all children’s critical care units across Ireland and the UK.
The recommended number of nurses per ICU bed is 5.5 in these units. During 2020, CHI at Crumlin had 5.82, but CHI at Temple Street had 5.46.
Children aged under one year took up over two-thirds (68%) of beds during 2020 across both units. In Crumlin, 21% were less than one month old and in Temple Street, 17% were less than one month old.