• Article
  • April 27, 2018

Opioid Ingestion Leading to Increase in PICU Admissions

Rising number of children need PICU treatment following opioid ingestion.

As the number of children seeking opioid-related medical care continues to rise, hospital leaders wanted to know how that growing number affected the use of pediatric critical care resources. Research published in Pediatrics detailed how the number of children who required hospitalization for opioid ingestions increased significantly between 2004 and 2015, while opioid-related admissions to the pediatric intensive care unit (PICU) nearly doubled.

The study, Opioid-related Critical Care Resource Utilization in U.S. Children's Hospitals, is the first of its kind to explore how often children who ingest opioids require the use of critical care resources.

In the study, an analysis of Pediatric Health Information System (PHIS) data assessed admissions to the PICU and the use of naloxone, vasopressors and ventilation to treat kids who ingested opioids. The data from 31 hospitals found:

  • 3,647 children required opioid-related hospitalizations
  • 43 percent of children hospitalized for opioid-related ingestion required PICU admission, representing a 35 percent increase
  • Children younger than 6 years old represented one-third of hospitalizations for opioid-related ingestion. The majority were between 12 and 17 years old.

Doctors also diagnosed opioid ingestion and poisoning more often. The PHIS data showed a significant and steady rise in opioid-related diagnoses among all age groups of children. Matt Hall, Ph.D., a co-author on the study and principal biostatistician at Children's Hospital Association, says the study is a reminder that the United States opioid crisis is not just an adult problem.

"It was interesting to see that almost half of these kids had accidental ingestions," says Hall. "Somehow, they're getting access to their parent's opioids or someone else's. But it's accidental, not intentional."

Front line caregivers in children's hospitals had anecdotal evidence they were seeing more kids in the PICU because of illness related to prescription painkillers and illegal drugs like heroin. Hall says with this PHIS data, researchers could quantify and confirm what caregivers were seeing.

The authors concluded efforts to cut back on adult prescription opioid use have not reduced opioid ingestion by children. "We need to think about solutions for children," says Hall. "The adult interventions are not working, and we need solutions to dampen this increase that we're seeing in pediatrics."

About the study authors
Jason Kane, M.D., associate professor of pediatrics at University of Chicago Medicine Comer Children's Hospital, designed the study and was the lead author. Hall collected data providing initial analysis and interpretation. Allison Bartlett, M.D., assistant professor of pediatrics at University of Chicago Medicine Comer Children's Hospital, provided input to the study design and data interpretation. Jeffrey Colvin, M.D., associate professor of pediatrics at Children's Mercy Kansas City, contributed interpretation of data.

Send questions or comments to magazine@childrenshospitals.org.