Secondary Logo

Share this article on:

Abstract P-003: ESCALATIONS TO VARIOUS CARDIORESPIRATORY SUPPORTS AFTER PEDIATRIC RAPID RESPONSE EVENTS ARE ASSOCIATED WITH UNIQUE PRECEDING PHYSIOLOGIC PATTERNS

Bavare, A.1; Abela, K.2; Morgan, A.2; Gagne, V.3; Patel, R.3; Rusin, C.1; Roy, K.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 48
doi: 10.1097/01.pcc.0000537460.11100.82
Poster Abstracts

1Baylor College of Medicine, Pediatrics, Houston, USA

2Texas Childrens Hospital, Pediatrics, Houston, USA

3Texas Childrens Hospital, Medical Informatics, Houston, USA

Back to Top | Article Outline

Aims & Objectives:

Rapid response events (RRE) frequently result in unplanned admissions to ICU and may subsequently need various ICU interventions. We hypothesized that distinct preceding physiologic patterns are associated with escalation to individual types of cardio-respiratory supports post RRE. Such association can guide prediction tools, with potential utility in prognostication and resource allocation.

Back to Top | Article Outline

Methods

After institutional review board approval, we screened all RREs in a tertiary pediatric academic hospital to identify and review events with escalation of support within 24 hours post RRE. Support categories included: 1-Non-invasive ventilation, 2-Mechanical ventilation 3-Pressors and 4-Mixed. Controls were RREs with no escalation of support. We examined vital signs (VS): oxygen saturations, heart and respiratory rates recorded every 2 seconds by bedside monitors for four-hours prior to support escalation or after RRE (controls). We created VS histograms with Sickbay research platform and compared them pairwise with Kolmogorov-Smirnov test.

Back to Top | Article Outline

Results

During a two-year period 1841 RREs and 236 (13%) escalation events occurred in our hospital. The median patient age was 2.29 years [IQR-0.5–10] for support escalation events, 62% were males and 26 (11%) died before discharge. Table depicts the characteristics and outcomes of various support categories. Figure shows VS histograms. [P value for each pair-wise comparison: <0.01]

Table

Table

Figure

Figure

Back to Top | Article Outline

Conclusions

Mortality is high among RREs that subsequently need cardio-respiratory support and preceding physiologic patterns are unique between individual types of supports and differ from non-support controls.

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