Clinical-demographic profile, critical care and outcome of children admitted into a level III intensive care unit in southern Nigeria

Specialized services are provided in Intensive Care Units (ICU) during critical illnesses, but there are limited ICU bed spaces for children in developing settings with dire consequences. The aim of this paper was to evaluate the clinical indications, treatments and short-term outcomes of children admitted into a mixed ICU at our centre. This study adopted a retrospective design. Data collection was done using a structured form comprising sections on each participant’s clinical-demographic information, diagnoses, treatments, sub-specialty reviews, mechanical ventilation parameters, and outcomes. The data were extracted from patient’s files over a five-year period. Descriptive and inferential analyses were done; p <0.05 was considered significant. A total of 858 patients, including 74 (8.6%) children, were managed in the ICU during the study period. The mean age of the children was 6.9±4.3 years. Thirty-seven (50%) were transferred to the ICU from the Children's Emergency Room (CHER). Severe sepsis was diagnosed in 11 (14.9%) of the participants, bronchopneumonia in 2 (2.7%) and meningitis in 6 (8.2%). Also, 24 (32.4%) participants were admitted into ICU post-surgery. Sixteen (21.7%) needed mechanical ventilation. Their mean Fraction of Inspired Oxygen (FiO2) was 69.8% (±0.97), and their mean Oxygen Saturation (SpO2) was 93.4% (±3.83). Co-management involved respiratory (16.2%), neurology (4.1%), and cardiology subspecialties. Their mean duration of ICU admission was 6.2±3.9 days. Forty-three participants (58.1%) died, and 40.5% were discharged to the ward. Paediatric intensive care is deliverable in a mixed ICU, but there is suboptimal survival of children. There is a need to boost paediatric ICU resources in the setting.