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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2010

01-04-2010 | Review

Systematic review of paediatric alert criteria for identifying hospitalised children at risk of critical deterioration

Authors: Susan M. Chapman, Michael P. W. Grocott, Linda S. Franck

Published in: Intensive Care Medicine | Issue 4/2010

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Abstract

Introduction

Unrecognised or untreated clinical deterioration can lead to serious adverse events, including cardiopulmonary arrest and unexpected death. Paediatric alert criteria aim to identify children with early signs of physiological instability that precede clinical deterioration so that experienced clinicians can intervene with the aim of reducing serious adverse events and improving outcome.

Purpose

To identify the number and nature of published paediatric alert criteria and evaluate their validity, reliability, clinical effectiveness and clinical utility.

Method

Systematic review of studies identified from electronic and citation searching and expert informants.

Results

Eleven studies fulfilled the inclusion criteria and described ten paediatric alert criteria. Six studies described the introduction and use of the paediatric alert criteria in practice, four examined the development and testing of the paediatric alert criteria, and one described both. There was marked variability across all aspects of the paediatric alert criteria, including the method of development, and the number and type of component parameters. Five studies explored the predictive validity of the paediatric alert criteria, but only three reported appropriate methodology. Only one study evaluated reliability, and none evaluated clinical utility of paediatric alert criteria.

Conclusions

Evidence supporting the validity, reliability and utility of paediatric alert criteria is weak. Studies are needed to determine which physiological parameters or combinations of parameters, best predict serious adverse events. Prospective evaluation of validity, reliability and utility is then needed before widespread adoption into clinical practice can be recommended.
Appendix
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Metadata
Title
Systematic review of paediatric alert criteria for identifying hospitalised children at risk of critical deterioration
Authors
Susan M. Chapman
Michael P. W. Grocott
Linda S. Franck
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-009-1715-x

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