Profile and Outcome Analysis of Paediatric Admissions into a General Intensive Care Unit in Nigeria: Is There a Need for a Paediatric Intensive Care Unit?

Abstract

Background: The care of critically ill children remains one of the most demanding and challenging aspects of the field of paediatrics. This form of care for children is being given in general Intensive Care Units meant for both adults and children in many centres in developing countries. The outcome of paediatric patients in the described setting is worth evaluating. Is there a need for Paediatric Intensive Care Units?

Objective: Toaudit the profile and outcome of paediatric patients admitted into the general Intensive Care Unit (ICU) of the University of Benin Teaching Hospital, Benin City, Nigeria.

Methods: A retrospective study in which records of admissions over a one-year period (January-December 2011) were obtained from the ICU records. Information retrieved included age, sex, diagnosis, duration of stay in the unit, use or non-use of mechanical ventilation and outcome.

Results: Fifty-two children, 17.4% of the total (298 patients) ICU admission, aged between two days and 17 years (mean age being 6.7 ± 5.8 years) were studied. Male: female ratio was 1.5: 1. Trauma (30.8%), post-surgical cases (21.2%) and respiratory disease (19.2%) were the major indications for admission with road traffic accidents making most (75%) of the trauma cases (traumatic brain injury [TBI]). Mortality rate was 36.5% while 63.5% were transferred to the paediatric wards for further management. TBI accounted for the largest number of deaths (26.3%) in the unit, followed by burns (15.8%) and intracranial tumours (10.5%).

Conclusion/ Recommendation: Paediatric admissions in our general intensive care unit are mainly trauma-related and mortality is high. Perhaps the establishment of a PICU which will be dedicated solely for the management of critically ill children coupled with training of more staff especially in the paediatric sector and provision of necessary facilities/equipment may help reduce mortality in them.

Keywords: Paediatric Admissions, Intensive Care Unit, Outcome.