Abstract：
OBJECTIVE: The aim of the present study was to assess the predictors of need for paediatric intensive care unit (PICU) admission for inter-hospital transfer patients to a tertiary paediatric hospital ED on high flow (HF) or continuous positive airway pressure (CPAP) ventilation.
METHODS: Single-centre retrospective study of patients transferred to the state\'s tertiary paediatric hospital. Demographic information and disease management information was obtained.
RESULTS: Between October 2021 and September 2022, 53 patients were transferred to the tertiary hospital on HF or CPAP. Of these, 23 required admission to PICU. Those admitted to PICU had a higher median fraction of inspired oxygen than those not admitted (0.4 vs 0.3, respectively, P = 0.013). Patients transported by road (vs flight) were more likely (20/23 patients, RR = 3.15, P = 0.016) to be admitted to PICU (56% vs 18%). Those who had received CPAP prior to or during transfer were more likely to require PICU admission (P = 0.012).
CONCLUSIONS: We have demonstrated that children who require CPAP to manage their respiratory disease are more likely to require PICU care on transfer to the tertiary paediatric hospital. In addition, those patients being transferred from secondary metropolitan hospitals after a trial of HF are also likely to require PICU care. This suggests that these patients should be directly admitted to PICU, allowing for improved patient experience and flow as well as reducing unnecessary ED resource utilisation.
METHODS: Single-centre retrospective study of patients transferred to the state\'s tertiary paediatric hospital. Demographic information and disease management information was obtained.
RESULTS: Between October 2021 and September 2022, 53 patients were transferred to the tertiary hospital on HF or CPAP. Of these, 23 required admission to PICU. Those admitted to PICU had a higher median fraction of inspired oxygen than those not admitted (0.4 vs 0.3, respectively, P = 0.013). Patients transported by road (vs flight) were more likely (20/23 patients, RR = 3.15, P = 0.016) to be admitted to PICU (56% vs 18%). Those who had received CPAP prior to or during transfer were more likely to require PICU admission (P = 0.012).
CONCLUSIONS: We have demonstrated that children who require CPAP to manage their respiratory disease are more likely to require PICU care on transfer to the tertiary paediatric hospital. In addition, those patients being transferred from secondary metropolitan hospitals after a trial of HF are also likely to require PICU care. This suggests that these patients should be directly admitted to PICU, allowing for improved patient experience and flow as well as reducing unnecessary ED resource utilisation.
摘要：
目的：本研究的目的是评估高流量（HF）或持续气道正压通气（CPAP）通气的医院间转院患者到三级儿科医院ED的儿科重症监护病房（PICU）入院需求的预测因素。
方法：对转入该州三级儿科医院的患者进行单中心回顾性研究。获得人口统计信息和疾病管理信息。
结果：在2021年10月至2022年9月之间，有53例患者因HF或CPAP被转移到三级医院。其中,23需要进入PICU。入院的PICU患者的吸入氧气中位数高于未入院的患者（分别为0.4和0.3，P=0.013)。通过公路(vs飞行)运送的患者更有可能(20/23患者，RR=3.15，P=0.016）进入PICU（56％vs18％）。那些在转院前或转院期间接受过CPAP的患者更有可能需要进入PICU（P=0.012）。
结论：我们已经证明，需要CPAP治疗呼吸道疾病的儿童在转移到三级儿科医院时更有可能需要PICU护理。此外,那些在HF试验后从二级大城市医院转院的患者也可能需要PICU护理.这表明这些患者应该直接进入PICU，允许改善患者体验和流量，并减少不必要的ED资源利用。
方法：对转入该州三级儿科医院的患者进行单中心回顾性研究。获得人口统计信息和疾病管理信息。
结果：在2021年10月至2022年9月之间，有53例患者因HF或CPAP被转移到三级医院。其中,23需要进入PICU。入院的PICU患者的吸入氧气中位数高于未入院的患者（分别为0.4和0.3，P=0.013)。通过公路(vs飞行)运送的患者更有可能(20/23患者，RR=3.15，P=0.016）进入PICU（56％vs18％）。那些在转院前或转院期间接受过CPAP的患者更有可能需要进入PICU（P=0.012）。
结论：我们已经证明，需要CPAP治疗呼吸道疾病的儿童在转移到三级儿科医院时更有可能需要PICU护理。此外,那些在HF试验后从二级大城市医院转院的患者也可能需要PICU护理.这表明这些患者应该直接进入PICU，允许改善患者体验和流量，并减少不必要的ED资源利用。
