Department of Anaesthesia and Intensive Care, Palmerston North Hospital, Palmerston North, New Zealand
Crit Care Resusc. 1999 Sep;1(3):234-8.
To report Palmerston North Hospital's (PNH) recent experiences with paediatric admissions to the general Intensive Care Unit (ICU), and to identify any aspects relevant to regionalisation of paediatric intensive care.
Retrospective review of the ICU database and admission register to enable clinical and demographic profiling of all paediatric (aged < 15 years) admissions to PNH ICU from 1996 to 1998. Observed and predicted mortalities were compared using the Paediatric Index of Mortality (PIM).
Seventy-five paediatric patients had 76 admissions, comprising 7.4% of ICU admissions during the study period. Forty-eight (64%) were male, and 59 (79%) of the patients received mechanical ventilatory support. The median ICU stay was 21.5 hours (range 0.1 to 568 hours). There were 3 deaths in the ICU, and one following ICU discharge but prior to hospital discharge, compared with 6.37 predicted deaths. The median PIM score overall was 5.3% predicted probability of death (range 0.8 - 61.4%), with 6 patients (7.9%) having a PIM score of greater than 30%. Fifteen patients (20%) were transferred to tertiary services.
If the PNH experience reflects that of other similar institutions, then non-tertiary ICUs admit small numbers of critically ill paediatric patients who tend to be of low to moderate severity, but who cover the full spectrum of severity. Most cases can be well managed locally, but appropriate referral and transfer is an important component in the delivery of a rational and integrated paediatric intensive care service.
报告帕默斯顿北医院（PNH）近期小儿重症监护病房（ICU）收治情况，并确定与儿科重症监护区域化相关的任何方面。
回顾性分析 ICU 数据库和入院登记册，以对 1996 年至 1998 年期间所有入住 PNH ICU 的儿科（<15 岁）患者进行临床和人口统计学分析。使用儿科死亡率指数（PIM）比较观察死亡率和预测死亡率。
75 名儿科患者有 76 次住院，占研究期间 ICU 总住院人数的 7.4%。48 名（64%）为男性，59 名（79%）患者接受机械通气支持。ICU 中位住院时间为 21.5 小时（0.1-568 小时）。ICU 内死亡 3 例，ICU 出院后但在医院出院前死亡 1 例，而预测死亡 6.37 例。总体中位数 PIM 评分为 5.3%预测死亡率（0.8-61.4%），6 名患者（7.9%）PIM 评分>30%。15 名患者（20%）转往三级服务。
如果 PNH 的经验反映了其他类似机构的经验，那么非三级 ICU 收治的重症儿科患者数量较少，病情倾向于低到中度严重程度，但涵盖了所有严重程度的范围。大多数病例可以在当地得到很好的管理，但适当的转介和转移是提供合理和综合儿科重症监护服务的重要组成部分。
