Riley Children's Health Annual Report 2023 – 2024

CARDIAC CRITICAL CARE CRITICAL CARE

RESEARCH HIGHLIGHTS

■ Founding member and coordinating center: Collaborative Research in Pediatric Cardiac Intensive Care (CoRe- PCICS) network; 34 active U.S. sites participating in several ongoing research projects ■ Riley Children’s is part of the Pediatric Cardiac Critical Care Consortium (PC4), which uses registry data from more than 60 congenital heart programs to evaluate best practices and drive improvements. ■ We are actively enrolling in several prospective observational cohort studies and clinical trials—some funded by the National Institutes of Health and the Centers for Disease Control and Prevention. Our CVICU team remains active in studies focused on aspects of multiorgan dysfunction, including ARDS, sepsis, renal failure and extracorporeal membrane oxygenation (ECMO) support.

The expert cardiac critical care physicians at Riley Children’s Health provide specialized care for critically ill newborns, infants, children and adolescents with congenital and acquired heart disease. Our high-acuity, high-volume CVICU includes 23 beds for CVICU patients and an eight-bed specialized neonatal ICU.

DIRECTOR Riad Lutfi, MD Associate Professor of Clinical Pediatrics, IU School of Medicine > Connect with Dr. Lutfi on Doximity.

PROGRAM DISTINCTIONS

Advanced technologies ■ Ventricular assist devices (VAD) – We offer a wide range of circulatory support devices to support patients in bridge-to-transplant or bridge-to-recovery circumstances. ■ Continuous renal replacement therapy (CRRT) – In addition to a multidisciplinary CRRT program, Riley Children’s offers aquapheresis to remove excess fluid accumulation in critically ill neonates and children. ■ Etiometry software – All CVICU rooms are equipped with this FDA-approved software visualization application to collect, store and present ICU data in near real-time.

■ Ranked among the leading pediatric heart programs in the nation by U.S. News & World Report ■ Only program in Indiana to offer pediatric heart transplantation and mechanical circulatory support capability ■ Indiana’s only pediatric hospital with a formal extracorporeal cardiopulmonary resuscitation (ECPR) program

9 board certified physicians (plus multiple board certified neonatologists and physicians in other specialties)

>

See full team member list

NOTABLE PUBLICATIONS Pediatric Critical Care Medicine: January 2023 Inter-Rater Reliability of Delirium Screening of Infants in the Cardiac ICU: A Prospective, Observational Study American Journal of Respiratory and Critical Care Medicine: January 2023 Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document Chest: May 2023 Operational Definitions Related to Pediatric Ventilator Liberation Pediatrics: August 2023 Factors Associated With Improved Pediatric Resuscitative Care in General Emergency Departments

High-volume pediatric ECMO center ■ 55 patients treated with ECMO in 2023. ■ Over the past five years, our overall survival rate for ECMO patients is nearly 60% (above the national average).

Risk-adjusted CVICU Surgical Mortality * 3.79% 2.22%

Risk-adjusted CVICU Medical Mortality *

Cardiac Arrest in the CVICU

3.97%

Our ECMO program is designated a Platinum Level Center of Excellence by the

2.96% 3.2%

2.92%

Extracorporeal Life Support Organization. To date, we have treated more than 1,200 patients with ECMO.

Riley Children’s All PC4 ** facilities

Riley Children’s All PC4 ** facilities

Riley Children’s All PC4 ** facilities

Additional 2023 outcome measures

Postoperative Severity – Adjusted CVICU Length of Stay

Major Complications – Unadjusted

ALTERNATIVE COMPLICATIONS

CASES

OUT OF

RILEY CHILDREN’S

ALL PC4 ** FACILITIES

CLABSI per 1,000 line days (central line-associated bloodstream infection)

0.44 per 1,000

2

4,596

1.21 per 1,000

23.5

19

11 days

CAUTI per 1,000 catheter days (catheter-associated urinary tract infection)

0.65 per 1,000

9.53 days

1

1,540

0.95 per 1,000

Unplanned extubation per 100 ventilator days

0.45 per 100

13

2,893

0.29 per 100

Riley Children’s All PC4 ** facilities

Riley Children’s All PC4 ** facilities

SSI per 100 surgical procedures (surgical site infection)

0 per 100

0

720

1.5 per 100

* Risk adjustment is a methodological approach incorporating unique patient characteristics that impact patient outcomes and are unrelated to the quality of care delivered by the care team or hospital. ** Pediatric Cardiac Critical Care Consortium | Charts reflect July 1, 2022 – June 30, 2023 , outcomes.

Annual Report 2023 – 2024

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