Skip to main content
SpringerLink
Log in

Infant Intensive Care Unit: Is it Time to Change?

  • Original Article
  • Published:
Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To assess the effect of the Infant intensive care unit (InICU), a specialized unit for critically ill infants established in 2016 in authors’ hospital, on infant mortality and compare the outcome with the current Pediatric intensive care units (PICU).

Methods

In this retrospective cross-sectional study, two groups were defined; the first included expired patients aged 1 mo to 2 y admitted to PICU before the establishment of the InICU (the PICU group). The second included age-matched expired patients admitted to the InICU (the InICU group). Data were recorded using a questionnaire.

Results

The authors found that the age, sex, underlying diseases, the leading cause of admission to the ICU, time of death, hospital and ICU length of stay, and the pediatric index of mortality 2 (PIM 2) score were same between the two groups. The incidence of mortality in the PICU group was 10.66 in 1000 person-month. This value was 6.37 for the InICU group (P-value <0.001). The relative risk of mortality of patients admitted to the PICU group compared to the InICU group was 1.67 (P-value <0.001).

Conclusions

Establishment of age specific InICU for infants may be beneficial in reducing infant mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Reisner-Sénélar L. The birth of intensive care medicine: björn Ibsen’s records. Intensive Care Med. 2011;37:1084–6.

    Article  PubMed  Google Scholar 

  2. Epstein D, Brill JE. A history of pediatric critical care medicine. Pediatr Res. 2005;58:987–96.

    Article  PubMed  Google Scholar 

  3. Gartner LM, Gartner CB, Gluck L, Butterfield LJ. The care of premature infants: historical perspective. Health. 1992;92:2786.

    Google Scholar 

  4. Downes JJ. The historical evolution, current status, and prospective development of pediatric critical care. Crit Care Clin. 1992;8:1–22.

    Article  CAS  PubMed  Google Scholar 

  5. Hardin AP, Hackell JM; Committee on Practice and Ambulatory Medicine. Age limit of pediatrics. Pediatrics. 2017;140:e20172151.

  6. Centers for Disease Control and Prevention. Child Development: Infants (0–1 years) [Internet]. 2021. Available at: https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/infants.html. Accessed on 8 Jan 2024.

  7. Abera S, Adjiwanou V. Multilevel analysis of infant mortality and its risk factors in South Africa. Int J Popul Studies. 2017;3:43–56.

    Google Scholar 

  8. Millennium Development. Goals (MDGs) [Internet]. Available at: https://www.who.int/news-room/fact-sheets/detail/millennium-development-goals-(mdgs). Accessed on 16 Dec 2023.

  9. Puri P. Pediatric Surgery: General Principles and Newborn Surgery. 1st ed. Berlin, Germany: Springer; 2020.

    Book  Google Scholar 

  10. Rosenberg DI, Moss MM; American Academy of Pediatrics Section on Critical Care, American Academy of Pediatrics Committee on Hospital Care. Guidelines and levels of care for pediatric intensive care units. Pediatrics. 2004;114:1114–25.

  11. Guidelines for developing admission and discharge policies for the pediatric intensive care unit. American Academy of Pediatrics. Committee on Hospital Care and Section of Critical Care. Society of Critical Care Medicine. Pediatric Section Admission Criteria Task Force. Pediatrics. 1999;103(4 Pt 1):840–2. PMID: 10103320.

  12. CDC. Infection Control [Internet]. Centers for Disease Control and Prevention. 2023. Available at: https://www.cdc.gov/infectioncontrol/index.html. Accessed on 17 Oct 2023.

  13. Slater A, Shann F, Pearson G. Paediatric Index of Mortality (PIM) Study Group. PIM2: a revised version of the Paediatric Index of Mortality. Intensive Care Med. 2003;29:278–85.

    Article  PubMed  Google Scholar 

  14. PIM2 [Internet]. Medscape.com. Available at: https://reference.medscape.com/calculator/368/pim2. Accessed on 17 Oct 2023.

  15. Lang TA, Altman DG. Basic statistical reporting for articles published in biomedical journals: Statistical Analyses and Methods in the Published Literature or the SAMPL guidelines. Int J Nurs Stud. 2015;52:5–9.

    Article  PubMed  Google Scholar 

  16. Krmpotic K, Lobos AT. Clinical profile of children requiring early unplanned admission to the PICU. Hosp Pediatr. 2013;3:212–8.

    Article  PubMed  Google Scholar 

  17. Valavi E, Aminzadeh M, Shirvani E, Jaafari L, Madhooshi S. The main causes of mortality in pediatric intensive care unit in south west of Iran. Zahedan J Res Med Sci. 2018;20:e63006.

    Article  Google Scholar 

  18. Al-Eyadhy A, Temsah M-H, Hasan GM, et al. Causes, timing, and modes of death in a tertiary pediatric intensive care unit: five years’ experience. Saudi Med J. 2021;42:1186–94.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Polito A, Combescure C, Levy-Jamet Y, Rimensberger P; Swiss Society of Intensive Care Medicine. Long-stay patients in pediatric intensive care unit: diagnostic-specific definition and predictors. PLoS One. 2019;14:e0223369.

  20. Pollack MM, Holubkov R, Reeder R, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN). PICU length of stay: factors associated with bed utilization and development of a benchmarking model. Pediatr Crit Care Med. 2018;19:196–203.

  21. Abdelatif RG, Mohammed MM, Mahmoud RA, Bakheet MAM, Gima M, Nakagawa S. Characterization and outcome of two pediatric intensive care units with different resources. Crit Care Res Pract. 2020;2020:5171790.

    PubMed  PubMed Central  Google Scholar 

  22. Tyagi P, Tullu MS, Agrawal M. Comparison of pediatric risk of mortality III, pediatric index of mortality 2, and pediatric index of mortality 3 in predicting mortality in a pediatric intensive care unit. J Pediatr Intensive Care. 2018;7:201–6.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gandhi J, Sangareddi S, Varadarajan P, Suresh S. Pediatric index of mortality 2 score as an outcome predictor in pediatric intensive care unit in India. Indian J Crit Care Med. 2013;17:288–91.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sankar J, Singh A, Sankar MJ, Joghee S, Dewangan S, Dubey N. Pediatric index of mortality and PIM2 scores have good calibration in a large cohort of children from a developing country. Biomed Res Int. 2014;2014:907871.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Salamati P, Talaee S, Eghbalkhah A, Chaman R, Mokhtari Z, Azarshahin M. Validation of the pediatric index of mortality-2 scoring system in a single pediatric intensive care unit in Iran. Iran J Pediatr. 2012;22:481–6.

    PubMed  PubMed Central  Google Scholar 

  26. Als LC, Nadel S, Cooper M, Pierce CM, Sahakian BJ, Garralda ME. Neuropsychologic function three to six months following admission to the PICU with meningoencephalitis, sepsis, and other disorders: a prospective study of school-aged children. Crit Care Med. 2013;41:1094–103.

    Article  PubMed  Google Scholar 

  27. Als LC, Tennant A, Nadel S, Cooper M, Pierce CM, Garralda ME. Persistence of neuropsychological deficits following pediatric critical illness. Crit Care Med. 2015;43:e312–15.

    Article  PubMed  Google Scholar 

  28. Zaitoun R, Aly RH, Rezk AR. Impact of paediatric intensive care unit admission on neurocognitive function in children. Egypt Pediatr Associ Gaz. 2022;70. https://doi.org/10.1186/s43054-022-00114-1.

  29. de Sonnaville ESV, Oosterlaan J, Ghiassi SA, et al. Long-term neurocognitive outcomes after pediatric intensive care: exploring the role of drug exposure. Pediatr Res. 2023;94:603–10.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran

    Mehrnaz Olfat, Meisam Sharifzadeh, Seyed Abbas Hassani, Mehrdad Goudarzi & Masoud Mohammadpour

  2. Division of Pediatric Intensive Care, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Mehrnaz Olfat, Meisam Sharifzadeh, Seyed Abbas Hassani & Masoud Mohammadpour

  3. Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Mehrnaz Olfat

  4. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Rayeheh Hosseinzadeh

  5. Department of Anesthesiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Mehrdad Goudarzi

Authors
  1. Mehrnaz Olfat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rayeheh Hosseinzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meisam Sharifzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seyed Abbas Hassani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mehrdad Goudarzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masoud Mohammadpour
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RH. The first draft of the manuscript was written by MO and MM critically edited the manuscript. All authors also commented on previous versions of the manuscript and approved the final manuscript. MM will act as guarantor for this manuscript.

Corresponding author

Correspondence to Masoud Mohammadpour.

Ethics declarations

Conflict of Interest

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Olfat, M., Hosseinzadeh, R., Sharifzadeh, M. et al. Infant Intensive Care Unit: Is it Time to Change?. Indian J Pediatr (2024). https://doi.org/10.1007/s12098-024-05032-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12098-024-05032-1

Keywords

Search

Navigation