title: Unplanned intensive care unit admission after general anaesthesia in children: A single centre retrospective analysis.
abstract: OBJECTIVE
  To determine the main causes for unplanned admission of children to the paediatric intensive care unit (PICU) following anaesthesia in our centre. To compare the results with previous publications and propose a data sheet for the prospective collection of such information.
  
  
  METHODS
  Inclusion criteria were any patient under 16 years who had an unplanned post-anaesthetic admission to the PICU from 1999 to 2010 in our university hospital. Age, ASA score, type of procedure, origin and causes of the incident(s) that prompted admission and time of the admission decision were recorded.
  
  
  RESULTS
  Out of a total of 44,559 paediatric interventions performed under anaesthesia during the study period, 85 were followed with an unplanned admission to the PICU: 67% of patients were younger than 5 years old. Their ASA status distribution from I to IV was 13, 47, 39 and 1%, respectively. The cause of admission was anaesthetic, surgical or mixed in 50, 37 and 13% of cases, respectively. The main causes of anaesthesia-related admission were respiratory or airway management problems (44%) and cardiac catheterisation complications (29%). In 62%, the admission decision was taken in the operating room.
  
  
  CONCLUSIONS
  Unplanned admission to the PICU after general anaesthesia is a rare event. In our series, most cases were less than 5 years old and were associated with at least one comorbidity. The main cause of admission was respiratory distress and the main type of procedure associated with admission was cardiac catheterisation.
authors.affiliation: Department of anaesthesiology, CHU Dinant-Godinne, avenue G.-Therasse 1, 5530 Yvoir, Belgium. Electronic address: johnmitchell0277@yahoo.fr.
authors.forename: John
authors.initials: J
authors.lastname: Mitchell
authors.affiliation: Paediatric ICU, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium. Electronic address: stephan.clementdeclety@uclouvain.be.
authors.forename: Stephan
authors.initials: S
authors.lastname: Clément de Clety
authors.affiliation: Department of anaesthesiology, CHU Dinant-Godinne, avenue G.-Therasse 1, 5530 Yvoir, Belgium. Electronic address: edith.collard@uclouvain.be.
authors.forename: Edith
authors.initials: E
authors.lastname: Collard
authors.affiliation: Department of anaesthesiology, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium. Electronic address: marc.dekock@uclouvain.be.
authors.forename: Marc
authors.initials: M
authors.lastname: De Kock
authors.affiliation: Paediatric ICU, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium. Electronic address: thierry.detaille@uclouvain.be.
authors.forename: Thierry
authors.initials: T
authors.lastname: Detaille
authors.affiliation: Paediatric ICU, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium. Electronic address: laurent.houtekie@uclouvain.be.
authors.forename: Laurent
authors.initials: L
authors.lastname: Houtekie
authors.affiliation: Department of anaesthesiology, CHU Dinant-Godinne, avenue G.-Therasse 1, 5530 Yvoir, Belgium. Electronic address: laurence.jadin@uclouvain.be.
authors.forename: Laurence
authors.initials: L
authors.lastname: Jadin
authors.affiliation: Department of anaesthesiology, CHU Dinant-Godinne, avenue G.-Therasse 1, 5530 Yvoir, Belgium. Electronic address: laurent.bairy@uclouvain.be.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bairy
authors.affiliation: Department of anaesthesiology, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium. Electronic address: francis.veyckemans@uclouvain.be.
authors.forename: Francis
authors.initials: F
authors.lastname: Veyckemans
mesh_terms: D000293:Adolescent; D000367:Age Factors; D058109:Airway Management / Q000009:adverse effects; D000768:Anesthesia, General / Q000009:adverse effects*; D006328:Cardiac Catheterization / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D009873:Operating Rooms / Q000458:organization & administration; D010343:Patient Admission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy; D012128:Respiratory Distress Syndrome / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Paediatric intensive care; Quality insurance indicator; Unplanned admissions