The Clinical Impact of Pediatric Pulmonologist Involvement in Intensive Care Units: Bridging Expertise and Outcomes

Introduction: Respiratory illnesses are a major cause of mortality and morbidity in pediatric and neonatal intensive care units (ICUs). This study aims to determine the impact of pediatric pulmonologist (PP) consultation on children in ICUs and assess differences in clinical outcomes. Methods: This single-center, retrospective, cross-sectional cohort study included children aged 0–18 years for whom PP consultations were requested between June 2022 and June 2023. Children were divided into two groups based on the median time from ICU admission to the consultation request. Group 1(n=221) received consultations within 14 days, defined as early consultation, while Group 2 (n=66) received consultations after 14 days, defined as late consultation. We compared demographic, clinical, and radiologic characteristics and the length of stay (LOS) in the hospital, ICU, and mechanical ventilator (MV). Results: Two hundred eighty-seven children were consulted by PPs. The most common reasons for the PP consultation were respiratory failure (39.4%), preoperative evaluation (14.6%), pneumonia (8.7%), atelectasis (5.9%), and suspicion of foreign body aspiration (5.6%). The median LOS in the hospital was 33 (IQR=61) days, in the ICU was 13 (IQR=33) days, and on the MV was 10.50 (IQR=30.50) days. Group 1 had significantly lower LOS in the hospital, ICU, and MV than Group 2 (p<0.001 for all). We found that being monitored on a mechanical ventilator (p < 0.001), being consulted for prolonged intubation or respiratory failure (p < 0.001), and being consulted by a PP after a median of 14 days are the main contributors to prolonged ICU LOS. Conclusions: Early PP consultation for children treated in the PICU and NICU may be associated with better outcomes. Nevertheless, the retrospective nature of our study, the lack of risk scoring data for patients, and the numerous factors that can influence the length of stay in the ICU and hospital for pediatric patients, necessitate further comprehensive research to substantiate our findings.