G36(P) Outcomes of infants transferred from the neonatal intensive care to the paediatric ward and paediatric intensive care after 44 weeks corrected gestational age. (12th March 2018)

• Record Type: Journal Article
• Authors: Crawford, K; Kamupira, SZ; Morley, S; Kelsall, AW
• Is Part Of: Archives of disease in childhood. Volume 103(2018)Supplement 1
• Page Start: A14
• Page End: A14
• Publication Date: 2018-03-12
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2018-rcpch.34
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aim: NHS England has outlined the Neonatal Intensive Care Unit (NICU) service to be for infants who are generally (but not exclusively)<44 weeks corrected gestational age (CGA). There are implications for the Paediatric Intensive Care Unit (PICU) and general paediatric wards in terms of managing this workload, and transitioning complex infants. Following challenges in accommodating some of these cases within our services, we conducted a study to assess the workload and outcomes of infants transferred from NICU after 44 weeks CGA over a 5 year period. Methods: Eligible infants transferred from NICU between 1/09/2010 – 31/08/2015 were identified from the Standardised Electronic Neonatal Database (SEND) and PICU databases. Information was extracted from the SEND discharge summaries and medical records regarding transition of care. Results: 26 infants were identified. A mean of 4 (1–6) infants were transitioned annually to PICU or the paediatric wards. Median birth gestation was 36+ 2 (23+ 6 –41+ 1 ) weeks, weight of 2400 (515–4480) grams. Median transition age was 46+ 1 (44+ 0 –52+ 6 ) weeks, weight of 3417 (1890–6170) grams. 11 of the 26 infants identified were transferred from NICU to PICU. Median length of stay (LOS) on PICU was 28 (1–241) days, mean 47 days. PICU occupancy per annum was 517 days, 13% of the annual bed occupancy (3754 days). 22 infants were transferred to the general paediatric wards, including some of whom were initially on PICU. Median LOS on the general paediatric ward was 11 (1–145) days, total of 591 days annually. No child died before discharge from hospital. Conclusion: This small group of complex infants constitute a high workload for both PICU and the general paediatric wards. The majority of infants remaining in hospital post 44 weeks CGA had undergone surgery during the neonatal period. The knowledge obtained from this study will help in planning the timely transition of these infants to paediatric services. This may help prevent local capacity issues to paediatric services by neonates awaiting repatriation around the region and familial separation.