J Pediatr Intensive Care 2022; 11(03): 201-208
DOI: 10.1055/s-0040-1722204
Original Article

Characteristics of Medically Transported Critically Ill Children with Respiratory Failure in Latin America: Implications for Outcomes

1   Division of Pediatric Intensive Care, Department of Pediatrics, Casa de Galicia, Montevideo, Uruguay
,
2   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital El Carmen de Maipú, Santiago, Chile
3   Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
,
2   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital El Carmen de Maipú, Santiago, Chile
4   Departamento de Pediatría, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
,
3   Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
5   Pediatric Intensive Care Division, Departamento de Pediatría, Facultad de Medicina, Clínica Alemana, Santiago, Chile
,
6   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital Clínico La Florida Dra. Eloísa Díaz Insunza, Santiago, Chile
,
A. Donoso
6   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital Clínico La Florida Dra. Eloísa Díaz Insunza, Santiago, Chile
,
J.A. Bravo-Serrano
7   Pediatric Intensive Care Division, Departamento de Pediatría, Caja Nacional de Salud, La Paz, Bolivia
,
M. Carbonell
8   Pediatric Intensive Care Division, Departamento de Pediatría, Médica Uruguaya, Montevideo, Uruguay
,
C. Courtie
9   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital de Sanidad Militar, Montevideo, Uruguay
,
A. Fernández
10   Pediatric Intensive Care Division, Departamento de Pediatría, Asociación Española, Montevideo, Uruguay
,
L. Martínez-Arroyo
11   Pediatric Intensive Care Division, Departamento de Pediatría, COMEPA, Paysandú, Uruguay
,
J. Martínez
9   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital de Sanidad Militar, Montevideo, Uruguay
,
S. Menta
12   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital Regional de Tacuarembó, Tacuarembó, Uruguay
,
13   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital Regional de Salto, Salto, Uruguay
,
A. Wegner
14   Pediatric Intensive Care Division, Departamento de Pediatría, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
,
8   Pediatric Intensive Care Division, Departamento de Pediatría, Médica Uruguaya, Montevideo, Uruguay
,
15   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital General de Medellín, Colombia
16   Pediatric Intensive Care Division, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquía, Colombia
,
17   Pediatric Intensive Care Division, Departamento de Pediatría, Hospital Juan Pablo II, Corrientes, Argentina
,
1   Division of Pediatric Intensive Care, Department of Pediatrics, Casa de Galicia, Montevideo, Uruguay
,
18   Pediatric Intensive Care Division, Departamento de Pediatría, Johns Hopkins University School of Medicine, Baltimore, United States
,
19   Pediatric Intensive Care Division, Departamento de Pediatría, Departamento de Pediatría, Sociedad de Cirugía Hospital de San José, Bogotá, Colombia
20   Pediatric Intensive Care Division, Departamento de Pediatría, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
21   Pediatric Intensive Care Division, Departamento de Pediatría, Universidad Nacional de Colombia, Bogotá, Colombia
,
On behalf of LARed Network › Author Affiliations
Funding This study was funded by Fondo Nacional de Ciencia y Tecnología, Gobierno de Chile, FONDECYT no.: 11160463 to FD for on-line tools, registry development, data analyses, and web-based environment construction.

Abstract

Several challenges exist for referral and transport of critically ill children in resource-limited regions such as Latin America; however, little is known about factors associated with clinical outcomes. Thus, we aimed to describe the characteristics of critically ill children in Latin America transferred to pediatric intensive care units for acute respiratory failure to identify risk factors for mortality. We analyzed data from 2,692 patients admitted to 28 centers in the Pediatric Collaborative Network of Latin America Acute Respiratory Failure Registry. Among patients referred from another facility (773, 28%), nonurban transports were independently associated with mortality (adjusted odds ratio = 9.4; 95% confidence interval: 2.4–36.3).

Authors' Contributions

J.A.S. and F.D. equally contributed to this research as main authors. They were involved in planning and designing the study and participated in all stages of the project. F.D., J.A.S., and M.J.N. conceived the idea. F.D., J.A.B.S., N.M.F., S.G.D., C.C., and P.C. were involved in development of the data extraction questionnaire.


F.D. and P.V.H. analyzed the data and described the results. J.C.J.B., J.A.B.S., M.J.N., R.J., L.M.A., A.W., A.F., A.D., C.C., and S.R.K. contributed to the interpretation of the results.


J.A.S. took the lead in writing the manuscript in consultation with F.D., P.C., and A.D. J.A.B.S., J.C.J.B., A.F., L.M.A., L.P.O., C.Co, C.C., J.M., M.J.N., S.R.K., and S.M. contributed to the discussion in accordance with the results.


All authors were involved in data collection and manuscript preparation and provided critical feedback to the analysis and discussion.


F.D., J.A.S., P.V.H., and S.G.D. supervised the whole project.


F.D., J.A.S., and P.V.H. are the guarantors of and take responsibility for the content of the manuscript. All authors have made substantial contributions to the research, provided final approval of the version to be published, and have agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors have read and approved the manuscript.


Note

Patients admitted to pediatric intensive care units in Latin America for respiratory failure are frequently referred from an outside facility. In this study, we found an independent association between referral from nonurban areas and mortality. This valuable insight can be used to improve quality of care for critically ill children who are transferred from nonurban centers in Latin America.


Collaborators

Argentina: Hospital Durand, Buenos Aires: Fernández A.; Hospital Juan Pablo II, Corrientes: Muzzio S.; Hospital Regional Olga Stucky de Rizzi, Reconquista: Cidral E., Mansur A.


Bolivia: Hospital Materno Infantil Boliviano Japonés, Trinidad: Céspedes Lesczinsky M., Velasco Z.; Hospital Regional San Juan de Dios, Tarija: Casson Rodríguez N.


Chile: Hospital El Carmen, Maipú: Córdova T.; Hospital Regional del Libertador Bernardo O’Higgins, Rancagua: González Moraga M.; Hospital Regional, Antofagasta: Pietroboni Fuster P.; Complejo Asistencial Dr. Víctor Ríos Ruíz, Los Ángeles: Aránguiz Quintanilla D., Sepúlveda J.


Colombia: Clínica Infantil Colsubsidio, Bogotá: Pardo R.


Costa Rica: Hospital Nacional de niños, Dr. Carlos Sáenz Herrera”: Rosales Fernández J., Sanabria S.


Ecuador: Hospital Carlos Andrade Marín, Quito: Guachichulca R., Hospital Inglés, Quito: Farez J.


Uruguay: Hospital Policial, Montevideo: Ferré A., España M.; Círculo Católico, Montevideo: Benech E., Carro M.; Sanatorio Casa de Galicia, Montevideo: Alonso B., Varela F.; Hospital Evangélico, Montevideo: Matrai L., Mislej C.; Sanatorio CAMDEL, Minas: Castro L.; Sanatorio COMECA, Canelones: Caggiano M.J., Talasimov C.; Hospital Salto, Salto: Franco A.




Publication History

Received: 18 August 2020

Accepted: 20 November 2020

Article published online:
20 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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