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Abstract O-44: ORGANIZATIONAL CHARACTERISTICS AND RESOURCES IN LATIN-AMERICAN PEDIATRIC INTENSIVE CARE UNITS. PRELIMINARY REPORT OF REAL-CIP (REALIDAD EN AMERICA LATINA DE CUIDADOS INTENSIVOS PEDIÁTRICOS) STUDY.

Diaz, F.1,2,3; Carvajal, C.4,5; González-Dambrauskas, S.6; Serra, A.7; Monteverde-Fernández, N.8; Nuñez, M.J.2; Cruces, P.9,10

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 19
doi: 10.1097/01.pcc.0000537386.99956.bf
Oral Abstracts
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1Clinica Alemana de Santiago, Pediatrics- Unidad de Cuidados Intensivos Pediátricos, Santiago, Chile

2Hospital Padre Hurtado, Pediatrics- Área de Cuidados Críticos, Santiago, Chile

3Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Pediatrics- Medicina Intensiva Infantil, Santiago, Chile

4Centro de Investigación e Inovación en Informática Médica CI3, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile

5Clinica Alemana de Santiago, Departamemnto de Informática Médica, Santiago, Chile

6Casa de Galicia, Cuidados Intensivos Pediátricos Especializados, Montevideo, Chile

7Casa de Galicia, Cuidados Intensivos Pediatricos, Montevideo, Uruguay

8Médica Uruguaya Corporacioón Médica de Asistencia Médica, Unidad de Cuidados neonatales y Pediatricos, Montevideo, Uruguay

9Hospital el Carmen de Maipú, Unidad de Paciente Crítico Pediátrico, Santiago, Chile

10Universidad Andres Bello, Centro de Investigación de Medicina Veterinaria- Escuela de Medicina Veterinaria- Facultad de Ecología y Recursos Naturales-, Santiago, Chile

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Aims & Objectives:

To describe organizational characteristics and resources of PICUs in Latin-America.

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Methods

Web-based survey submitted to Latin-American PICUs.

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Results

50 out 98 centers responded the survey from 10 countries (38% Chile, 20% Uruguay, 20% Argentina). Centers characteristics: 66% public, 74% mixed [intermediate (IMCU) and intensive care (PICU)], 76% academic, 24% have critical care training program. PICU beds median 7(6,12) and IMCU 6(5,10). Physician/patient ratio was 0.3(0.2,0.5) and 0.25(0.16,0.4) for PICU and IMCU (p<0.05 for difference between centers). 24h intensivist presence was full in 56%, but <50% in 32% centers. Nurse/patient ratio was 0.5 (0.33,0.5) and 0.33 (0.2,0.5) for PICU and IMCU; nurse technician(clinical-assistant)/patient ratio 0.33 (0.25,0.5) (p<0.05). 37% centers had respiratory therapist dedicated to ICU, 54% available during night shift. Clinical protocols use for cardiac arrest 94%, Sepsis 80%, MV 78%, weaning 66%. All centers have invasive and non-invasive MV, HFNC was available in 78%. Scores use for pain56%, sedation62%, withdrawal42% and delirium12%. Severity scores use: PIM2/3 70%, PRISM 26%, PELOD 24%. Basic monitoring was available in all centers; advanced monitoring availability: cardiac output 26%, PAC 6%, FHM 32%, NIRS 22% and volumetric capnography 50%. Rescue therapies available: iNO50%, surfactant60%, TRRC60%, ECMO16%, TTM48%. 24h blood chemistry, Blood cultures and CRP were available in all centers, but lactate only in 94% and procalcitonin 64%.

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Conclusions

This survey highlights substantial variation in critical care organization and resources in Latin-American PICUs. These disparities must be considered for guidelines and collaborative interventional studies. On future research, is the impact of these differences on clinical outcomes will be studied.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies