The impact of transfers from neonatal intensive care to paediatric intensive care

Objectives: Infants receiving care from neonatal intensive care unit (NICU) can develop chronic problems and be transferred to a paediatric intensive care unit (PICU) for ongoing care. There is concern that such infants may take up a large amount of PICU resource, but this is not evidence based. We determined the impact of such transfers. Methods: We reviewed 10 years of NICU admissions to two tertiary PICUs, which had approximately 12,000 admissions during that period. Results: Sixty-seven infants, gestational age at birth 34.7 (IQR 27.1-38.8) weeks and postnatal age on transfer 81 (IQR 9-144) days were admitted from NICUs. The median (IQR) length of stay was 12 (4-41) days. The 19 infants born <28 weeks of gestation had a greater median length of stay (32, range IQR 10-93 days) than more mature born infants (7.5, IQR 4-26 days) (p=0.003). The median cost of PICU stay for NICU transfers was 23,800 pound (range 1,205-1,034,000) per baby. The total cost of care for infants transferred from NICUs was 6,457,955 pound. Conclusions: Infants transferred from NICUs were a small proportion of PICU admissions but, particularly those born <28 weeks of gestation, had prolonged stays which needs to be considered when determining bed capacity.