Pediatric critical care capacity in Canada: a national cross-sectional study

Abstract

AbstractBackgroundPediatric intensive care unit (PICU) capacity is a current and future health system challenge in Canada. Despite experiencing two pandemics over the last 15 years and surges in PICU admissions every winter, the bed capacity of Canadian PICUs and their ability to accommodate surges in demand are unknown.MethodsWe conducted an internet-based cross-sectional survey to gather information from Canadian PICUs regarding PICU characteristics, medical staffing, therapies provided, and anticipated challenges related to surge management. The survey was completed by a representative of each PICU and validated by PICU Directors. Quantitative survey results were summarized as counts, proportions, and ratios while qualitative response was analyzed using inductive content analysis.ResultsRepresentatives from all19 PICUslocated in17 hospitalscompleted the survey and reported having275(217level 3 &58level 2) funded beds with298physical bed spaces. Two PICUs representing47beds (35Level 3 &12Level 2) are specialized cardiac ICUs. Roughly13385, 13419, 11430 and 12315Canadian children were admitted to these PICUs in the years 2018, 2019, 2020 & 2021, respectively. During a surge, PICUs reported being able to add5.9 ± 3.4 (range: 0 – 14)beds per unit and a total of108temporary surge beds. Several barriers for the successful implementation of surge plans were identified.InterpretationCanadian pediatric critical care capacity is comparable to other high-income countries, though our ability to respond to a pandemic/epidemic surge with significant pediatric critical illness may be limited.