Inter-unit management of neonates with congenital heart diseases between NICU and PICU

Abstract

Abstract Background: Neonates undergoing cardiac surgeries require highly specialized perioperative care. However, limited information is currently available on the impact of the preoperative location of neonates undergoing cardiac surgeries on the management and outcomes. This was a retrospective observational study that compared management patterns, morbidity, and mortality among infants before and after the renovation of the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) in a single university hospital. Methods: We retrospectively reviewed the medical records of neonates admitted to the University of Tokyo Hospital NICU who underwent cardiac surgery and were treated in the PICU during hospitalization. We collected data on infants born in two different time periods (“Before”: in 2017 and 2018, and “After”: in 2020 and 2021). The “Before” group comprised patients managed in the previous ward, while the “After” group included patients managed in the new ward. Results: Maternal age was higher and complicated cases were significantly more frequent in the “After” group (p<0.05). However, in-hospital mortality was similar between the two groups (p=0.98). Patients were exchanged between the NICU and PICU significantly more often in the “After” group (p<0.01). Patients in the “After” group left the PICU earlier after cardiac surgeries. Conclusions: The results of this retrospective analysis of a single center showed that management plans for neonates with congenital heart defects may be changed depending on the ward arrangement. Patients were transferred between the NICU and PICU more frequently when adjacent to each other, which enabled an earlier discharge from the PICU.