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J Pediatr Intensive Care 2022; 11(03): 221-225
DOI: 10.1055/s-0040-1722340
Original Article

Changes Adopted in Asian Pediatric Hospitals during the COVID-19 Pandemic: A Report from the Pediatric Acute and Critical Care COVID-19 Registry of Asia

Judith J. M. Wong 
1   Children’s Intensive Care Unit, Department of Pediatric Subspecialities, KK Women’s and Children’s Hospital, Singapore
2   Duke-NUS Medical School, Singapore
,
Qalab Abbas 
3   Pediatric Critical Care Medicine, Aga Khan University, Pakistan
,
Nattachai Anantasit 
4   Pediatric Department, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
,
Naoki Shimizu 
5   Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
,
Ririe F. Malisie 
6   Pediatric Emergency and Intensive Care Division, Child Health Department, Faculty of Medicine, Universitas Sumatera Utara, North Sumatra, Indonesia
,
Hongxing Dang 
7   Critical Care Treatment Center and Intensive Care Medicine, Children’s Hospital of Chongqing Medical University
,
Feng Xu 
7   Critical Care Treatment Center and Intensive Care Medicine, Children’s Hospital of Chongqing Medical University
,
Jacqueline S. M. Ong
8   Pediatric Intensive Care Unit, Khoo Teck Puat University Children’s Medical Institute, National University Hospital, Singapore
9   Department of Pediatrics, Yong Loo Lin School of Medicine, National University Hospital, Singapore
,
Pei Chuen Lee
10   Pediatric Intensive Care Unit, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Malayasia
,
Osamu Saito
11   Pediatric Intensive Care Unit, Tokyo Metropolitan Children's Medical Center
,
Kah Min Pon
12   Pediatric Intensive Care Unit, Hospital Pulau Pinang, Pulau Pinang, Malaysia
,
Takanari Ikeyama 
13   Division of Pediatric Critical Care Medicine, Aichi Children’s Health and Medical Center, Japan
,
Muralidharan Jayashree 
14   Pediatric Intensive Care and Emergency Units, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research Chandigarh, India
,
Rujipat Samransamruajkit 
15   Division of Pediatric Critical Care, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
,
Yibing Cheng
16   Emergency Department, Henan Children’s Hospital, Zhengzhou, Henan, China
,
Felix Liauw
17   Division of Pediatric Intensive Care Unit, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
,
Hiroshi Kurosawa 
18   Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Japan
,
Audrey A. N. Diaz
19   Pediatric Intensive Care Unit, Vicente Sotto Memorial Medical Center, Cebu, Philippines
,
Chin Seng Gan 
20   Department of Pediatrics, University Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
,
Furong Zhang
21   Department of Critical Care Medicine, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
,
Jan Hau Lee 
1   Children’s Intensive Care Unit, Department of Pediatric Subspecialities, KK Women’s and Children’s Hospital, Singapore
2   Duke-NUS Medical School, Singapore
,
Pediatric Acute Critical Care Medicine Asian Network › Author Affiliations Funding None.
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Abstract

There is wide variation in the overall clinical impact of novel coronavirus disease 2019 (COVID-19) across countries worldwide. Changes adopted pertaining to the management of pediatric patients, in particular, the provision of respiratory support during the COVID-19 pandemic is poorly described in Asia. We performed a multicenter survey of 20 Asian pediatric hospitals to determine workflow changes adopted during the pandemic. Data from centers of high-income (HIC), upper middle income (UMIC), and lower middle income (LMIC) countries were compared. All 20 sites over nine countries (HIC: Japan [4] and Singapore [2]; UMIC: China [3], Malaysia [3] and Thailand [2]; and LMIC: India [1], Indonesia [2], Pakistan [1], and Philippines [2]) responded to this survey. This survey demonstrated substantial outbreak adaptability. The major differences between the three income categories were that HICs were (1) more able/willing to minimize use of noninvasive ventilation or high-flow nasal cannula therapy in favor of early intubation, and (2) had greater availability of negative-pressure rooms and powered air-purifying respirators. Further research into the best practices for respiratory support are warranted. In particular, innovation on cost-effective measures in infection control and respiratory support in the LMIC setting should be considered in preparation for future waves of COVID-19 infection.

Keywords

novel coronavirus disease 2019 - respiratory disease - noninvasive ventilation - mechanical ventilation - infectious disease

Supplementary Material



Publication History

Received: 08 November 2020

Accepted: 30 November 2020

Article published online:
19 January 2021

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