PEDIATRICS Vol. 76 No. 5 November 1985, pp. 719-724
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Monitoring Patients in Pediatric Intensive Care

Murray M. Pollack MD1, Urs E. Ruttimann PhD1, Nancy L. Glass MD1, and Timothy S. Yeh MD1

1 From the Division of Critical Care Medicine, Departments of Anesthesiology and Pediatrics, Children's Hospital National Medical Center and George Washington University School of Medicine, Washington, DC, and Diagnostic Systems Branch, National Institutes of Health, Bethesda, Maryland

All admissions to a 16-bed multidisciplinary pediatric intensive care unit (PICU) were evaluated during two time periods totaling 13.5 months. Daily evaluations of therapeutic and monitoring care modalities were accomplished with the Therapeutic Intervention Scoring System (TISS) and daily assessments of severity of illness were done by using the Physiologic Stability Index. Of the 822 patients included in this study, 226 (27.5%) never received a therapy that could only be given in the PICU. These patients were known as the monitoring group and used 7.5% (297/3,969) of the bed days. The percentage of Therapeutic Intervention Scoring System points used by the monitoring patients was 3.6% (3,575/100,109). All patients who were monitored survived; 213 (94.2%) were classified as low mortality risk based on their level of physiologic stability. These data indicate that a significant percentage of PICU patients never receive a therapy that requires the PICU but only receive monitoring and routine care techniques. Significant reductions in PICU use could occur with more efficient usage.

Key Words: intensive care unit • cost control • critical care

Submitted on January 8, 1985
Accepted on March 25, 1985