Transition from neonatal to paediatric intensive care of very preterm-born children: a cohort study of children born between 2013 and 2018 in England and Wales.

Autor:	van Hasselt TJ; Department of Population Health Sciences, University of Leicester, Leicester, UK t.vanhasselt@nhs.net., Newman S; Parent of child with medical complexity, UK., Kanthimathinathan HK; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK., Davis PJ; Bristol Royal Hospital for Children, Bristol, UK., Draper ES; Department of Population Health Sciences, University of Leicester, Leicester, UK., Gale C; Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.; Centre for Paediatrics and Child Health, Imperial College London, London, UK., Battersby C; Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.; Centre for Paediatrics and Child Health, Imperial College London, London, UK., Seaton SE; Department of Population Health Sciences, University of Leicester, Leicester, UK.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI:	10.1136/archdischild-2024-327457
Abstrakt:	Objective: Following very preterm birth, some children require ongoing intensive care after the neonatal period and transition directly from neonatal units (NNUs) to paediatric intensive care units (PICUs) around term-corrected age.We aimed to understand, at a national level, characteristics and outcomes of children born very preterm who transitioned directly from NNUs to PICUs. Design: Retrospective cohort study, using data linkage of National Neonatal Research Database, Paediatric Intensive Care Audit Network and Office for National Statistics datasets. Setting: All NNUs and PICUs in England and Wales. Patients: Children born <32 gestational weeks between 1 January 2013 and 31 December 2018, admitted to NNUs, and who transitioned directly to PICU without return to NNU at ≥36 weeks corrected gestation age were included. Main Outcome Measures: Mortality, length of PICU stay, invasive ventilation in PICU (including via tracheostomy), PICU readmission until 2 years of age. Results: Direct NNU-to-PICU transitions occurred in 276 babies during the study period. An increasing yearly trend was observed: 36 transitions of babies born in 2013, 65 in 2018.Of this cohort, 22% of children died before their second birthday, 59% of survivors had ≥1 PICU readmission, 33% of children had long stays in PICU (≥28 days) and 25% received tracheostomy ventilation. Conclusions: An increasing number of very preterm children require ongoing intensive care at the end of their neonatal stay, with high rates of mortality and morbidity. Multidisciplinary involvement and planning around the time of transition from NNU to PICU, informed by national guidance, may be beneficial. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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