Irish Paediatric Critical Care Audit National Report 2023

This is the fourth national report published from the Irish Paediatric Critical Care Audit. This report provides detailed clinical data from 1,723 children admitted to the 2 Paediatric Critical Care Units in Ireland and describes key metrics and outcomes related to admissions and transports.

The report noted a 5% increase in the number of children admitted to PCCUs compared with 2022. As a result, the number of bed days delivered by the two PCCUs in 2023 was 11,164. Almost three-quarters (73%) of the bed days were provided in the Unit in CHI at Crumlin.

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Key Findings

The report highlights several key findings from 2023 that offer important insights into paediatric critical care activity. Unplanned admissions made up 68% of all cases, with a significant number involving children transferred from other hospitals. Notably, the number of children admitted to adult Intensive Care Units (ICUs) doubled to 148 cases. Respiratory conditions were the most common reason for admission to Paediatric Critical Care Units (PCCUs), accounting for 34% of cases, with a marked rise in respiratory syncytial virus (RSV) infections, particularly among infants. Encouragingly, the overall survival rate for children in PCCUs remained high at 97%. The report also records that four children, aged between 5 and 15, became organ donors, representing 9% of PCCU deaths.

Key Recommendations

Recommendation 1

Children’s Health Ireland (CHI) should continue planning for the required increase in the workforce of paediatric critical care medicine consultants, trainees, nurses and allied health professionals for the safe opening and operation of the National Children’s Hospital (NCH) Critical Care Unit with 32–42 beds. This should be part of a comprehensive published CHI workforce document that is in line with medical, nursing, and health and social care professional (HSCP) national standards.

Recommendation 2

A national paediatric respiratory extracorporeal life support (ECLS) programme should be progressed in CHI.

Recommendation 3

The Health Service Executive (HSE) should support the development of regional Paediatric High Dependency Units (PHDUs) in hospitals providing regional paediatric surgical facilities. It is essential that future planning includes regional investment in the development of regional PHDUs.

Recommendation 4

Continue the extension of specialist paediatric transport services to operate 24 hours per day, 7 days per week by resourcing the Irish Paediatric Acute Transport Service (IPATS).

Recommendation 5

Organ Donation Transplant Ireland (ODTI) and CHI should progress the appointment of organ donation personnel.

Recommendation 6

Raise awareness of the early recognition of signs of type 1 diabetes and diabetic ketoacidosis (DKA) in order to reduce the number of patients presenting with DKA.