Current status of pediatric neurocritical care in Argentina

Arch Argent Pediatr. 2020 Jun;118(3):204-209. doi: 10.5546/aap.2020.eng.204.
[Article in English, Spanish]

Abstract

Introduction: Patients with neurocritical injuries account for 10-16 % of pediatric intensive care unit (PICU) admissions and frequently require neuromonitoring.

Objective: To describe the current status of neuromonitoring in Argentina.

Methods: Survey with 37 questions about neuromonitoring without including patients' data. Period: April-June 2017.

Results: Thirty-eight responses were received out of 71 requests (14 districts with 11 498 annual discharges). The PICU/hospital bed ratio was 21.9 (range: 4.2-66.7). Seventy-four percent of PICUs were public; 61 %, university-affiliated; and 71 %, level I. The availability of monitoring techniques was similar between public and private (percentages): intracranial pressure (95), electroencephalography (92), transcranial Doppler (53), evoked potentials (50), jugular saturation (47), and bispectral index (11). Trauma was the main reason for monitoring.

Conclusion: Except for intracranial pressure and electroencephalography, neuromonitoring resources are scarce and active neurosurgery availability is minimal. A PICU national registry is required.

Introducción. Los pacientes con lesiones neurocríticas representan el 10-16 % de los ingresos a unidades de cuidados intensivos pediátricas (UCIP) y, frecuentemente, requieren neuromonitoreo. Objetivo. Describir el estado actual del neuromonitoreo en la Argentina. Métodos. Encuesta con 37 preguntas sobre neuromonitoreo sin incluir datos de pacientes. Período: abril-junio, 2017. Resultados. Se recibieron 38 respuestas a 71 solicitudes (14 distritos con 11 498 egresos anuales). La relación camas de UCIP/hospitalarias fue 21,9 (rango: 4,2-66,7). El 74 % fueron públicas; el 61 %, universitarias, y el 71 %, nivel 1. La disponibilidad fue similar entre públicas y privadas (porcentajes): presión intracraneana (95), electroencefalografía (92), doppler transcraneano (53), potenciales evocados (50), saturación yugular (47) e índice bispectral (11). El principal motivo de monitoreo fue trauma. Conclusión. Excepto la presión intracraneana y la electroencefalografía, los recursos de neuromonitoreo son escasos y la disponibilidad de neurocirugía activa es mínima. Se necesita un registro nacional de UCIP.

Keywords: intensive care units; intracranial pressure; pediatrics; status epilepticus; traumatic brain injury.

MeSH terms

  • Adolescent
  • Argentina
  • Child
  • Child, Preschool
  • Critical Care / methods
  • Critical Care / statistics & numerical data*
  • Critical Illness
  • Facilities and Services Utilization / statistics & numerical data*
  • Health Care Surveys
  • Health Resources / supply & distribution*
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Infections / diagnosis
  • Infections / therapy
  • Intensive Care Units, Pediatric / statistics & numerical data*
  • Neoplasms / diagnosis
  • Neoplasms / therapy
  • Neurophysiological Monitoring / instrumentation
  • Neurophysiological Monitoring / methods
  • Neurophysiological Monitoring / statistics & numerical data*
  • Status Epilepticus / diagnosis
  • Status Epilepticus / therapy
  • Trauma, Nervous System / diagnosis
  • Trauma, Nervous System / therapy