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Organizational Characteristics of European Pediatric Onco-Critical Care: An International Cross-Sectional Survey.
  • +15
  • Jeppe S.A. Nielsen,
  • Rachel Agbeko,
  • Jessica Bate,
  • Iolanda Jordan,
  • Christian Dohna-Schwake,
  • Jenny Potratz,
  • Andrea Moscatelli,
  • Gabriella Bottari,
  • John Pappachan,
  • Volker Witt,
  • Roman Crazzolara,
  • Angela Amigoni,
  • Agnieszka Mizia-Malarz,
  • María Sánchez Martín,
  • Jef Willems,
  • Luregn J. Schlapbach,
  • Marry Van den Heuvel-Eibrink,
  • Roelie Wösten-Van Asperen
Jeppe S.A. Nielsen
Rigshospitalet

Corresponding Author:jeppe.sylvest.angaard.nielsen@regionh.dk

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Rachel Agbeko
Newcastle University
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Jessica Bate
University Hospital Southampton NHS Foundation Trust
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Iolanda Jordan
Hospital Sant Joan de Deu
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Christian Dohna-Schwake
Universitat Duisburg-Essen - Campus Essen
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Jenny Potratz
Universitatsklinikum Munster
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Andrea Moscatelli
Istituto Giannina Gaslini
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Gabriella Bottari
Ospedale Pediatrico Bambino Gesu
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John Pappachan
Southampton General Hospital
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Volker Witt
St Anna Kinderspital GmbH
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Roman Crazzolara
Medizinische Universitat Innsbruck Department fur Frauenheilkunde
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Angela Amigoni
Azienda Ospedale Universita Padova
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Agnieszka Mizia-Malarz
ASP Katowice
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María Sánchez Martín
Hospital Universitario La Paz
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Jef Willems
Universiteit Gent
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Luregn J. Schlapbach
UniversitatsSpital Zurich
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Marry Van den Heuvel-Eibrink
Prinses Maxima Centrum voor Kinderoncologie
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Roelie Wösten-Van Asperen
Universitair Medisch Centrum Utrecht - Locatie Wilhelmina Kinderziekenhuis
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Abstract

Background: Intensified treatment protocols have improved survival of pediatric oncology patients. However, these treatment protocols are associated with increased treatment-related morbidity requiring admission to pediatric intensive care unit (PICU). We aimed to describe the organizational characteristics and processes of care for this patient group across PICUs in Europe. Methods: A web-based survey was sent to PICU directors or representative physicians between February and June 2021. Results: Responses were obtained from 77 PICUs of 12 European countries. Organizational characteristics were similar across the different countries of Europe. The median number of PICU beds was 12 (IQR 8-16). The majority of the PICUs was staffed by pediatric intensivists and had a 24/7 intensivist coverage. Most PICUs had a nurse-to-patient ratio of 1:1 or 1:2. The median numbers of yearly planned and unplanned PICU admissions of pediatric cancer patients were 20 (IQR 10-45) and 10 (IQR 10-30, respectively. Oncology specific practices within PICU were less common in participating centres. This included implementation of oncology protocols in PICU (30%), daily rounds of PICU physicians on the wards (13%), joint mortality and morbidity meetings or complex patients’ discussions (30% and 40%, respectively) and participation of parents during clinical rounds (40%). Conclusion: Our survey provides an overview on the delivery of critical care for oncology patients in PICU across European countries. Multidisciplinary care for these vulnerable and challenging patients remains complex and challenging. Future studies need to determine the effects of differences in PICU organization and processes of care on patients’ outcome.
01 Dec 2022Published in Frontiers in Pediatrics volume 10. 10.3389/fped.2022.1024273