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Díaz F, Kehr J, Cores C, et al. Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic. J Crit Care. 2021;68:59-65doi: 10.1016/j.jcrc.2021.12.004.
Díaz, F., Kehr, J., Cores, C., Rubilar, P., Medina, T., Vargas, C., & Cruces, P. (2021). Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic. Journal of critical care, 6859-65. https://doi.org/10.1016/j.jcrc.2021.12.004
Díaz, Franco, et al. "Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic." Journal of critical care vol. 68 (2021): 59-65. doi: https://doi.org/10.1016/j.jcrc.2021.12.004
Díaz F, Kehr J, Cores C, Rubilar P, Medina T, Vargas C, Cruces P. Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic. J Crit Care. 2021 Dec 15;68:59-65. doi: 10.1016/j.jcrc.2021.12.004. Epub 2021 Dec 15. PMID: 34922313; PMCID: PMC8672360.
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J Crit Care. 2021 Dec 15;68:59-65. doi: 10.1016/j.jcrc.2021.12.004. Epub 2021 Dec 15.

Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic.

Journal of critical care

Franco Díaz, Juan Kehr, Camila Cores, Patricia Rubilar, Tania Medina, Caroline Vargas, Pablo Cruces

Affiliations

  1. Unidad de Paciente Critico Pediátrico, Hospital El Carmen de Maipú, Santiago, Chile; Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile; LARed Network, Santiago, Chile.
  2. Unidad de Paciente Critico Pediátrico, Hospital El Carmen de Maipú, Santiago, Chile.
  3. Unidad de Paciente Critico Pediátrico, Hospital El Carmen de Maipú, Santiago, Chile; LARed Network, Santiago, Chile; Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile. Electronic address: [email protected].

PMID: 34922313 PMCID: PMC8672360 DOI: 10.1016/j.jcrc.2021.12.004

Abstract

PURPOSE: We aim to describe the action plan and clinical results of a COVID-19 unit for adult patient care in units intended for critically ill children, proposing a clinical/administrative framework.

METHODS: We reviewed the preparedness of the PICU team before the surge of cases of COVID-19 and the organizational/administrative issues to increase critical beds in a six-bed PICU allocated to adult critical care in a government-funded general hospital in Latin America. We analyzed the prospectively collected administrative/clinical data of severe COVID-19 cases admitted to PICU during the peak of the first wave of the pandemic.

RESULTS: We describe a 6-step preparedness plan: recruitment and education, admission criteria, children diversion, team hierarchy, and general and respiratory equipment. The 6-bed PICU was allocated to adult care for 20 weeks, progressively increasing capacity to a 23-bed dedicated COVID-19 unit managed by the PICU team. A six-block bed organizational units were implemented, and personnel increased from 40 to 125 healthcare workers in 24 h shifts. COVID-19 incidence in personnel was 0.5/1000 workdays. One hundred thirty-six patients were admitted, median age 59 (51,65) years old, 68% were male, and 63% had P/F ≤ 100. In addition, 48% received mechanical ventilation, the median length of stay was 7 (3,17), and in-hospital mortality was 15%.

CONCLUSIONS: We propose an organizational framework for the role of PICU in the hospital action plan to increase adult critical beds. The cohort of patients admitted to a PICU repurposed as a COVID-19 ICU had good outcomes. These data are valuable to plan coordinated actions of the healthcare system for future scenarios.

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: ARDS; COVID-19; Disaster response; PICU

Conflict of interest statement

Declaration of competing interest Authors declare no conflicts of interest.

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