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Adult COVID-19 Patients Cared for in a Pediatric ICU Embedded in a Regional Biothreat Center: Disease Severity and Outcomes.
Fernandes, Neil D; Cummings, Brian M; Naber, Catherine E; Salt, Michael D; Lok, Josephine; Yager, Phoebe H; Carroll, Ryan W.
  • Fernandes ND; Neil D. Fernandes, MD, Catherine E. Naber, MD, and Michael D. Salt, DO, are Pediatric Critical Care Fellows, MassGeneral Hospital for Children/Harvard Medical School, Boston, MA. Brian M. Cummings, MD, is Medical Director, Vice Chair, and a Pediatric Critical Care Physician; Josephine Lok, MD, is a
  • Cummings BM; Neil D. Fernandes, MD, Catherine E. Naber, MD, and Michael D. Salt, DO, are Pediatric Critical Care Fellows, MassGeneral Hospital for Children/Harvard Medical School, Boston, MA. Brian M. Cummings, MD, is Medical Director, Vice Chair, and a Pediatric Critical Care Physician; Josephine Lok, MD, is a
  • Naber CE; Neil D. Fernandes, MD, Catherine E. Naber, MD, and Michael D. Salt, DO, are Pediatric Critical Care Fellows, MassGeneral Hospital for Children/Harvard Medical School, Boston, MA. Brian M. Cummings, MD, is Medical Director, Vice Chair, and a Pediatric Critical Care Physician; Josephine Lok, MD, is a
  • Salt MD; Neil D. Fernandes, MD, Catherine E. Naber, MD, and Michael D. Salt, DO, are Pediatric Critical Care Fellows, MassGeneral Hospital for Children/Harvard Medical School, Boston, MA. Brian M. Cummings, MD, is Medical Director, Vice Chair, and a Pediatric Critical Care Physician; Josephine Lok, MD, is a
  • Lok J; Neil D. Fernandes, MD, Catherine E. Naber, MD, and Michael D. Salt, DO, are Pediatric Critical Care Fellows, MassGeneral Hospital for Children/Harvard Medical School, Boston, MA. Brian M. Cummings, MD, is Medical Director, Vice Chair, and a Pediatric Critical Care Physician; Josephine Lok, MD, is a
  • Yager PH; Neil D. Fernandes, MD, Catherine E. Naber, MD, and Michael D. Salt, DO, are Pediatric Critical Care Fellows, MassGeneral Hospital for Children/Harvard Medical School, Boston, MA. Brian M. Cummings, MD, is Medical Director, Vice Chair, and a Pediatric Critical Care Physician; Josephine Lok, MD, is a
  • Carroll RW; Neil D. Fernandes, MD, Catherine E. Naber, MD, and Michael D. Salt, DO, are Pediatric Critical Care Fellows, MassGeneral Hospital for Children/Harvard Medical School, Boston, MA. Brian M. Cummings, MD, is Medical Director, Vice Chair, and a Pediatric Critical Care Physician; Josephine Lok, MD, is a
Health Secur ; 19(4): 442-446, 2021.
Article in English | MEDLINE | ID: covidwho-978575
ABSTRACT
The objective of this study was to describe the clinical characteristics and outcomes of adult coronavirus disease 2019 (COVID-19) patients admitted to a pediatric intensive care unit (PICU), with assessment of respiratory clinical severity and outcomes when cared for by pediatric intensivists utilizing specific care processes. We conducted a retrospective cohort study of adult patients admitted to the 14-bed PICU of a quaternary referral center during the COVID-19 surge in Boston between April and June 2020. A total of 37 adults were admitted 28 tested COVID-19 positive and 9 tested COVID-19 negative. Of the COVID-19-positive patients, 21 (75%), were male and 12 (60.7%) identified as Hispanic/Latino. Comorbidities in the patients included diabetes mellitus (39.3%), hyperlipidemia (39.3%), and hypertension (32.1%). Twenty-four (85.7%) required mechanical ventilation, in whom the lowest median ratio of arterial oxygen partial pressure to fractional inspired pressure was 161.5 (141.0 to 184.5), the median peak positive end-expiratory pressure (PEEP) was 14 (12.0 to 15.8) cmH2O and 15 (62.5%) underwent an optimal PEEP maneuver. Twelve (50%) patients were proned for a median of 3.0 (3.0 to 4.8) days. Of the 15 patients who were extubated, 3 (20%) required reintubation. Tracheostomy was performed in 10 patients 3 after extubation failure and 7 for prolonged mechanical ventilation and weakness. Renal replacement therapy was required by 4 (14.3%) patients. There were 2 (7.1%) mortalities. We report detailed clinical outcomes of adult patients when cared for by intact pediatric critical care teams during the COVID-19 pandemic. Good clinical outcomes, when supported by adult critical care colleagues and dedicated operational processes are possible.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Intensive Care Units, Pediatric / Pediatricians / COVID-19 / Inpatients Type of study: Cohort study / Observational study / Prognostic study Limits: Child / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Health Secur Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Intensive Care Units, Pediatric / Pediatricians / COVID-19 / Inpatients Type of study: Cohort study / Observational study / Prognostic study Limits: Child / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Health Secur Year: 2021 Document Type: Article