Post by Nadica (She/Her) on Dec 12, 2024 0:36:15 GMT
Performance of Pediatric Intensive Care Unit (PICU) Before and After the Advancement of Resources Under COVID-19 Emergency Response and Health System Preparedness Package Phase II (ECRP-II): Single Center Experience - Published Dec 11, 2024
To the Editor: The upgradation of infrastructure, equipments/machines, and training of healthcare workers was done from January to June 2022 as per the standard norms [1]. We retrospectively analysed the data of PICU before (Time Period-I: July-2018 to June-2020) and after (Time Period-II: July-2022 to December-2023) the infrastructure changes, to compare mortality, leave against medical advice (LAMA) and unmet need of mechanical ventilation (MV). Variables collected were age, sex, system involvement on admission, discharge, requirement of respiratory support (non-invasive and invasive), PICU length of stay (LOS) in days, death and LAMA. A p-value of less than 0.05 was considered statistically significant.
The baseline characteristics of children are shown in Supplementary Table S1. There was significant decrease in LAMA (70/1016 vs. 97/918, p = 0.004) and unmet need of MV (45/645 vs. 131/437, p < 0.0001) whereas significant increase in LOS [14 (2.27, 18) vs. 7 (5, 12), p < 0.0001)] and discharge (630/1016 vs. 522/918, p = 0.02) during Time Period-II as compared to Time Period-I. The availability of medical equipments, supplies and provision of timely appropriate care on arrival to facility reduced LAMA and unmet need of MV during Time Period-II [2]. The reported mortality during the study periods were 299/918 (33%) and 316/1016 (31%) respectively and it is in accordance with published range of mortality (18–30%) [2, 3]. The overall mortality did not improve; this might be because of other factors which could not be analysed, like nurse bed ratio, surgical or non-surgical admission, multi-organ failure, healthcare associated infection and competency of staff etc.
ECRP-II was a one-time grant launched by Government of India in anticipation of 3rd wave of COVID-19 pandemic which enabled training of healthcare staff, upgradation/construction of infrastructure focused for Pediatric Critical Care and procurement of equipments/machines and supplies [4]. There was an improvement in the performance of PICU except for mortality. Recurring and non-recurring grants would be required for sustainability and functioning of established facilities developed under ECRP-II.
To the Editor: The upgradation of infrastructure, equipments/machines, and training of healthcare workers was done from January to June 2022 as per the standard norms [1]. We retrospectively analysed the data of PICU before (Time Period-I: July-2018 to June-2020) and after (Time Period-II: July-2022 to December-2023) the infrastructure changes, to compare mortality, leave against medical advice (LAMA) and unmet need of mechanical ventilation (MV). Variables collected were age, sex, system involvement on admission, discharge, requirement of respiratory support (non-invasive and invasive), PICU length of stay (LOS) in days, death and LAMA. A p-value of less than 0.05 was considered statistically significant.
The baseline characteristics of children are shown in Supplementary Table S1. There was significant decrease in LAMA (70/1016 vs. 97/918, p = 0.004) and unmet need of MV (45/645 vs. 131/437, p < 0.0001) whereas significant increase in LOS [14 (2.27, 18) vs. 7 (5, 12), p < 0.0001)] and discharge (630/1016 vs. 522/918, p = 0.02) during Time Period-II as compared to Time Period-I. The availability of medical equipments, supplies and provision of timely appropriate care on arrival to facility reduced LAMA and unmet need of MV during Time Period-II [2]. The reported mortality during the study periods were 299/918 (33%) and 316/1016 (31%) respectively and it is in accordance with published range of mortality (18–30%) [2, 3]. The overall mortality did not improve; this might be because of other factors which could not be analysed, like nurse bed ratio, surgical or non-surgical admission, multi-organ failure, healthcare associated infection and competency of staff etc.
ECRP-II was a one-time grant launched by Government of India in anticipation of 3rd wave of COVID-19 pandemic which enabled training of healthcare staff, upgradation/construction of infrastructure focused for Pediatric Critical Care and procurement of equipments/machines and supplies [4]. There was an improvement in the performance of PICU except for mortality. Recurring and non-recurring grants would be required for sustainability and functioning of established facilities developed under ECRP-II.