The impact of transfers from neonatal intensive care to paediatric intensive care.


Williams EE(1), Lee R(1), Williams N(2), Deep A(2), Subramaniam N(3), Dwarakanathan B(3), Dassios T(1)(4), Greenough A(1)(4)(5)(6).
Author information:
(1)Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
(2)Paediatric Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK.
(3)St George's Hospital Paediatric Intensive Care Unit, London, UK.
(4)Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK.
(5)The Asthma UK Centre for Allergic Mechanisms in Asthma, London, UK.
(6)NIHR Biomedical Research Centre based at Guy's and St Thomas NHS Foundation Trust and King's College London, London, UK.


OBJECTIVES: Infants receiving care from neonatal intensive care unit (NICU) can develop chronic problems and be transferred to a paediatric intensive care unit (PICU) for on-going care. There is concern that such infants may take up a large amount of PICU resource, but this is not evidence based. We determined the impact of such transfers. METHODS: We reviewed 10 years of NICU admissions to two tertiary PICUs, which had approximately 12,000 admissions during that period. RESULTS: Sixty-seven infants, gestational age at birth 34.7 (IQR 27.1-38.8) weeks and postnatal age on transfer 81 (IQR 9-144) days were admitted from NICUs. The median (IQR) length of stay was 12 (4-41) days. The 19 infants born <28 weeks of gestation had a greater median length of stay (32, range IQR 10-93 days) than more mature born infants (7.5, IQR 4-26 days) (p=0.003). The median cost of PICU stay for NICU transfers was £23,800 (range 1,205-1,034,000) per baby. The total cost of care for infants transferred from NICUs was £6,457,955. CONCLUSIONS: Infants transferred from NICUs were a small proportion of PICU admissions but, particularly those born <28 weeks of gestation, had prolonged stays which needs to be considered when determining bed capacity.