Prediction Of Shortage Of Intensive Care Beds For Children With Swine Flu (UK)

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Main Category: Swine Flu
Also Included In: Pediatrics / Children's Health;  Public Health
Article Date: 19 Nov 2009 - 0:00 PST

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Research published ahead of print in the Archives of Disease in Childhood reports that if UK swine flu resurges during the winter months, there may not be a sufficient amount of intensive care beds for one of the most seriously affected groups: children.

More than half of admissions to pediatric intensive care units (PICUs) are unplanned. Respiratory illness is the second largest cause of admission. It accounts for around one in four cases, and seasonal respiratory infections are putting extra demands on capacity.

Researchers from the University of Cambridge used a model developed by the US Centers for Disease Control to predict likely demand for critical care (FluSurge, version 2). They applied it for the UK's current provision: 303 intensive care beds for children spread over 25 regional centers.

In line with the Department of Health and the European Centre for Disease Prevention and Control recommendations, they estimated:

• an attack rate of 30 percent;
• a minimum stay of five days in intensive care;
• a pandemic lasting 12 weeks.

Based on age data, they estimated that 3.8 percent of the UK's population under 15 years of age admitted to hospital for swine flu would require critical care.

The authors say that hospital admission rates of 1 to 2 percent are considered to be reasonable when planning capacity.

According to their estimates, if the admission rate is 1 percent, around half of the UK's existing critical care capacity will be needed. If this rate reaches 2 percent, almost all the current capacity would be required.

In addition, critical care capacity for children varies considerably by region. Areas such as Wales, the South East Coast, and the East of England are likely to struggle to cope with increased demand, even at a 1 percent admission rate.

The authors say that given that half of all critical care admissions are unplanned, there is little range to cancel elective or planned procedures.

They suggest that while extremely sick children in district general hospitals are taken to specialist regional centers, these services will also come under pressure. The authors indicate that the calculations are uncertain as trends in infection and hospital admission rates for swine flu are still not clear.

But they write in conclusion: "It seems inevitable that PICUs will experience significant additional pressure this winter from admissions due to the pandemic."

"Modelling the impact of pandemic influenza A(H1N1) on UK paediatric intensive care demand"
A Ercole, D K Menon, D R O'Donnell
Online First Arch Dis Child 2009
doi 10.1136/adc.2009.171520
Archives of Disease in Childhood

Written by Stephanie Brunner (B.A.)
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