The pressure on Dutch pediatric intensive care units is high. There are many young patients with respiratory infections. The main culprit at the moment is the RS virus, which can cause severe pneumonia. Last week, planned operations on children were canceled in hospitals. This concerns operations on children for whom an IC bed must be available afterwards. That is “quite serious”, according to the Leiden University Medical Center (LUMC). In that hospital it concerns “very complex operations, for example pediatric heart operations, which you cannot and do not want to postpone for too long”.
It is not exceptional that the pressure is rising in children’s ICUs, doctors say. “The picture is no different from other years,” said the LUMC spokesperson. “We are not surprised,” says Károly Illy, chairman of the Dutch Pediatric Association. “Only we usually don’t see this until January.”
Illy thinks that corona may play a role in that shift: “Children have met a little less. They may have built up a little less resistance, so that the virus seizes its chance a little earlier.” In Groningen, young patients were sometimes transferred to Germany in other years, says Eduard Verhagen, head of the Beatrix Children’s Hospital, which is part of the UMC Groningen. “That is not possible now. It’s busy there too.”
The IC beds are now full, although that could be different in three hours
Edward Verhagen Head of Beatrix Children’s Hospital
Monday reported RTL News that there would be an ’emergency consultation’ between the seven Dutch children’s ICs in connection with the crowds, also NRC took over that message. This does not appear to be the case: on Tuesday a scheduled consultation took place between the hospitals. That is common during this period.
There is “no panic,” says Verhagen. An IC bed is currently being found for every young patient who needs it. “Almost always in their own city, or the city where the child presents itself, sometimes a place is found further on in the Netherlands.”
One hundred ICU beds
The Netherlands has about a hundred IC beds for children. How many of these are ‘open’ depends on the staff available. In Groningen there are now eighteen. Those beds are full, says Verhagen, although it is emphatically a snapshot. “It could just be different in three hours.” Sometimes the flow stops, he says, and then it is difficult to find a bed in a regular children’s ward for children who can leave the ICU.
The LUMC has twelve children’s IC beds, ten of which are occupied. “It has been tight for years,” says the spokesman. “The Executive Board has promised this week that we will build additional children’s IC beds in Leiden.”
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Pediatric IC beds are suitable for children from zero to eighteen years of age. To relieve the pressure, the UMCG transfers some older patients (aged sixteen, seventeen or eighteen) to the adult intensive care unit. Staff from that department also assist in the children’s IC.
Although you can’t just exchange patients and staff, says Verhagen. “Specialists work in a children’s ICU,” he says. “Nurses and doctors who are used to working with sometimes very young patients who hardly weigh anything.” Moreover, children often have different diseases than adults. “And the medication is also different, the infusions are smaller, the doses are different.”
Verhagen does see that exchanging personnel has become more common since corona. “During the pandemic, pediatric ICU staff actually helped provide adult patients with ICU care. You can see that working together is now easier and faster. That is what corona has brought us.”