The Clinical Impact of Pediatric Pulmonologist Involvement in Intensive Care Units: Bridging Expertise and Outcomes

Authors:
  • STSatı Özkan Tabakçı
    Satı Özkan Tabakçı
  • MYMurat Alperan Yavuz
    Murat Alperan Yavuz
  • MGMurat Yasin Gençoğlu
    Murat Yasin Gençoğlu
  • SUSalih Uytun
    Salih Uytun
  • IBIşıl Bilgiç
    Işıl Bilgiç
  • MÇMeltem Kürtül Çakar
    Meltem Kürtül Çakar
  • GDGamze Akça Dinç
    Gamze Akça Dinç
  • AÜAyyüce Ünlü
    Ayyüce Ünlü
  • BTBahar Ece Tokdemir
    Bahar Ece Tokdemir
  • HYHande Yetişgin
    Hande Yetişgin
  • ÇYÇelebi Yıldırım
    Çelebi Yıldırım
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Abstract
Introduction: Respiratory illnesses are a major cause of mortality and morbidity in pediatric and neonatal intensive care units (ICUs). This study aimed to determine the impact of pediatric pulmonologist (PP) consultation on children in ICUs and assess differences in clinical outcomes. Methods: This single-center, retrospective, cross-sectional cohort study included children aged 0–18 years for whom PP consultations were requested between June 2022 and June 2023. Children were divided into two groups based on the median time from ICU admission to the consultation request. Group 1 (n = 221) received consultations within 14 days, defined as early consultation, while group 2 (n = 66) received consultations after 14 days, defined as late consultation. We compared demographic, clinical, and radiologic characteristics and the length of stay (LOS) in the hospital, ICU, and mechanical ventilator (MV). Results: Two hundred eighty-seven children were consulted by PPs. The most common reasons for the PP consultation were respiratory failure (39.4%), preoperative evaluation (14.6%), pneumonia (8.7%), atelectasis (5.9%), and suspicion of foreign body aspiration (5.6%). The median LOS in the hospital was 33 (IQR = 61) days, in the ICU was 13 (IQR = 33) days, and on the MV was 10.50 (IQR = 30.50) days. Group 1 had significantly lower LOS in the hospital, ICU, and MV than group 2 (p < 0.001 for all). We found that being monitored on an MV (p < 0.001), being consulted for prolonged intubation or respiratory failure (p < 0.001), and being consulted by a PP after a median of 14 days are the main contributors to prolonged ICU LOS. Conclusions: Early PP consultation for children treated in the PICU and NICU may be associated with better outcomes. Nevertheless, the retrospective nature of our study, the lack of risk scoring data for patients, and the numerous factors that can influence the LOS in the ICU and hospital for pediatric patients necessitate further comprehensive research to substantiate our findings.

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