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DOI: 10.1055/s-0040-1722204
Characteristics of Medically Transported Critically Ill Children with Respiratory Failure in Latin America: Implications for Outcomes
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.![](https://www.thieme-connect.de/media/10.1055-s-00029029/202203/lookinside/thumbnails/10-1055-s-0040-1722204_2000120-1.jpg)
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
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