Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit.

BACKGROUND

There are few studies on the effect of intensivist staffing in pediatric intensive care units (PICUs) in Korea. We aimed to evaluate the effect of pediatric intensivist staffing on treatment outcomes in a Korean hospital PICU.

METHODS

We analyzed two time periods according to pediatric intensivist staffing: period 1, between November 2015 to January 2017 (no intensivist staffing, n=97) and period 2, between February 2017 to February 2018 (intensivists staffing, n=135).

RESULTS

Median age at admission was 5.4 years (range, 0.7-10.3 years) in period 1 and 3.6 years (0.2-5.1 years) in period 2 (P=0.013). The bed occupancy rate decreased in period 2 (75%; 73%-88%) compared to period 1 (89%; 81%-94%; P=0.015). However, the monthly bed turnover rate increased in period 2 (2.2%; 1.9%-2.7%) compared to period 1 (1.5%, 1.1%- 1.7%; P=0.005). In both periods, patients with chronic neurologic illness were the most common. Patients with cardiovascular problems were more prevalent in period 2 than period 1 (P=0.008). Daytime admission occurred more frequently in period 2 than period 1 (63% vs. 39%, P<0.001). The length of PICU stay, parameters related with mechanical ventilation and tracheostomy, and pediatric Sequential Organ Failure Assessment score were not different between periods. Sudden cardiopulmonary resuscitations occurred in two cases during period 1, but no case occurred during period 2.

CONCLUSIONS

Pediatric intensivist staffing in the PICU may affect efficient ICU operations.