Life-saving treatment for infants and children with very severe lung failure should be provided in Ireland

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Life-saving treatment should be provided in paediatric critical care units in Ireland for infants and children with very severe lung failure, according to Dr Martina Healy, Clinical Lead for the Irish Paediatric Critical Care Audit (IPCCA).

She said the lack of Respiratory Extra Corporeal Life Support (ECLS) in our PCCU, for critically ill paediatric patients continued to be a deficit in the care to critically ill children in Ireland and needed to be addressed by CHI and HSE.

She said this service, already available to congenital cardiac patients, could be extended to the respiratory group for a fraction of the current cost of transport and treatment abroad. There is no formally funded and resourced paediatric respiratory ECLS programme in the ROI.

Dr. Healy was launching the Irish Paediatric Critical Care Audit National Report 2020, which outlined activity and benchmarked outcomes of critical care provided to 1,399 sick children during 2020, which ranged from age groups under 25 weeks gestation up to 18 years of age, who were cared for across the two PCCUs in Ireland.  The audit also captures data on paediatric patients admitted to adult Intensive Care Units (ICUs), using data from the Irish National ICU Audit.

The report said that the number of critically ill children admitted to Ireland’s PCCUs in 2020 was affected by the onset of the COVID-19 pandemic in February 2020. While a slight decrease in activity was noted, with fewer admissions (9% decrease from 2019) and less bed days (decrease of 1,000 bed days from 2019), bed occupancy remained high (>85% in both Units). CHI at Crumlin, at 968, had the third-highest number of PCCU admissions of all Units in the UK and Ireland for 2020, , after Birmingham Children’s Hospital and Great Ormond Street Hospital, London.

The report recommended Paediatric Critical Care Units should monitor and review their out-of-hours and delayed discharges from the unit as this was not best practice and should be avoided as much as possible. During the evening and night time there was reduced medical and nursing staff availability on the wards, and it was less likely that a parent/guardian would be present to accompany the child if the discharge occurred during the night.