Where Should the Transition of Newborns Who are Technology Dependent and in Need of Support to Home Care in Turkey?

Abstract

Introduction: The discharge rates of newborns dependent on medical technology and in need of palliative care have increased. Specialized care units aimed to reduce patient load in neonatal intensive care units (NICU), and increase the quality of home care. In our country, there are few specialized care units for these patients. This study aimed to determine the characteristics of patients who were hospitalized in NICU and transferred to pediatric intensive care unit (PICU) due to continuing care. Methods: The data of patients who were hospitalized in NICU between January 1, 2008 and July 31, 2022 and transferred to PICU were analyzed. Results: Twenty (51%) of 39 patients were male, 46% had congenital anomaly(s), 33% had neurometabolic diseases. Fourty-nine percent (n=19) of patients died during PICU stay, 2.6% (n=1) died after discharge. Demographic findings of died and survived patients were similar. Ninety percent of patients received invasive respiratory support (IRS) for a median of 43 days during NICU, 97% received IRS for a median of 31 days during PICU. Percutaneous endoscopic gastrostomy (PEG) and tracheostomy were performed 31%, and 51% of patients, respectively. The median length of stay in NICU and PICU were 55 days and 37 days, respectively. The discharged patients had a higher rate of PEG or tracheostomy (p<0.05). Conclusion: Establishment of specialized care units is important to provide comprehensive, family-centered care to newborns who need palliative care, to reduce the burden on NICUs and PICUs. This study, which is first in our country, will lead to future studies for establishment of specialized care units.

Keywords

• pediatric intensive care
• palliative care
• neonatal intensive care