PICU Chronic Lung Disease Mortality and Morbidity (PLUM)

Abstract

Background: Children with Bronchopulmonary dysplasia (BPD) have increased incidence of respiratory illness, often necessitating Pediatric ICU admission. Little is known about the outcome of these admissions. Aim: This study aimed to determine clinical and demographic data of this cohort and determine factors affecting mortality and length of ICU stay. Oxygen requirement following a year after ICU admission was determined. Methods: Retrospective case-note review was performed. Patients with congenital cardiac abnormalities or chronic respiratory conditions like cystic fibrosis were excluded. Data were presented as descriptive statistics. Predictors of death and LOS were determined using Fisher’s exact test and univariate regression analyses. Results: Small numbers of deaths prohibited strong conclusions. Inotrope use (p<0.001), blood transfusion (p<0.001), use of inhaled nitric oxide (p=0.003) and a diagnosis of sepsis (p=0.004) were related to mortality. Age at admission, gestational age at birth, weight, oxygen requirement prior to admission or length of stay did not increase the odds of mortality. Inotrope usage (p=0.027), transfusion requirements (p=0.044) and a sepsis diagnosis (p=0.005) were significantly associated with length of ICU stay >7 days. More than half the patients, who were followed up, had an oxygen requirement at 6-month and 12-month follow up. Conclusion: Patients admitted with chronic lung disease to PICU with pulmonary hypertension and sepsis has long ICU stay and more odds of dying. More than half of the children who survive to 6-month and 12-month follow up have ongoing oxygen requirement. Studies in larger populations of children with BPD will help in more accurate prognostication following PICU admission.