The number of children admitted to paediatric critical care units (PCCUs) increased by 14 per cent in 2021 and 2022, according to a new report.
The Irish Paediatric Critical Care Audit, conducted by the National Office of Clinical Audit, examined data on 7,575 infants and children admitted to the State's two PCCUs – Children's Health Ireland at Crumlin and Temple Street – between 2018 and 2022.
The research looked at bed days, length of stay, age breakdown, diagnosis and mortality trends over the five-year period.
PCCUs had high occupancy rates (above 85 per cent) in 2021-2022, the report found, "particularly in winter months", reflecting the 'winter surge' seen across the health system.
However, the report authors noted: "A detailed analysis of these admissions shows that an increasing majority were secondary to seasonal viruses and respiratory syncytial virus (RSV) pathogen."
The development of new vaccines for RSV could be a factor in reducing these types of admissions, the report added.
CHI Crumlin had occupancy rates consistently over 95 per cent, above the recommended national standard of 85 per cent, while the number of qualified nurses per bed at CHI Temple Street remained below the recommended standard.
While Temple Street saw a 34 per cent increase in PCCU admissions in 2022 compared to 2018, Crumlin accounted for 76 per cent of bed days in each of the years examined.
The report also highlighted that most PCCU admissions were unplanned in 2021 and 2022.
"Developing regional Paediatric High Dependency Unit (PHDU) capacity would ease the strain on PCCUs.
"The plan to expand paediatric regional surgical units to Model 4 hospitals means that children can be treated at a local level for non-specialist surgical procedures. However, this needs to be backed up by the provision of PHDU to allow for enhanced postoperative care in a PHDU if required," the authors added.
Looking at 'crude mortality rate', the research found deaths among PCCU patients remained very low (4 per cent), the majority of which were in the neonatal age group.
Cardiovascular diagnosis were the leading factor in mortalities at Crumlin, while "external causes of accident or injury" was the most common factor of those recorded at Temple Street.
The report's recommendations echo issues being seen across the wider health service, with the report authors calling for an emphasis to be placed on workforce, particularly regarding recruitment and retention.
