Reuters Health: Hospitals may consider using children's ICU resources for COVID-19 patients
By Carolyn Crist
During a pandemic that primarily affects adults, hospitals may need to shift their neonatal and pediatric intensive-care unit (ICU) resources to help coronavirus patients, a group of pediatricians and bioethicists say.
"Traditionally, the way we think about pandemics is that they have a generalized effect across the population with the very young and the very old being more affected," said lead author Dr. Ian Wolfe of the Children's Mercy Bioethics Center in Kansas City, Missouri.
"This pandemic is unique in that it is disproportionately affecting adults," he told Reuters Health by email. "We saw that this difference would impact the way we think about resource allocation."
Dr. Wolfe and colleagues discussed two ways that resources could be shared - by importing patients or by exporting resources. Children's ICUs could care for older patients in their wards, or doctors and medical equipment could be moved temporarily to adult ICUs.
"Without adequate thought and planning, this could lead to problematic scenarios where either adults who are not allotted a ventilator die while resources at a children's hospital sit unused, a PICU is overutilized with adult patients affecting resources available for children, or resources from children's hospitals are poorly allocated to where they do not optimize benefit," Dr. Wolfe said.
For example, many children's hospitals have increased their admission age for patients to 25 while preparing for the pandemic, but the specific age may not be practical, he added.
"Still, with anticipated excess capacity, we believe that children's hospitals can meet their primary mission," the authors write. "This bending of usual standards is appropriate and serves the principle of justice."
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Learn more about the Children's Mercy Bioethics Center