Background:
Severe burn injuries in children may necessitate paediatric intensive care unit (PICU) admissions due to the complexity of care required. This study aims to describe the characteristics and outcomes of paediatric burn patients admitted to the PICU over more than a decade.
Methods:
A retrospective review was conducted of all paediatric burn admissions to the PICU between 2014 and 2025 at the Women’s and Children’s Hospital in South Australia. Demographic data, burn characteristics, interventions, and outcomes were analysed.
Results:
During the study period, 4,816 paediatric burn cases were recorded, with 1,617 requiring hospital admission, and 34 (2.1%) necessitating PICU care. The mean patient age was 3 years 8 months (range: 2 months–14 years), with a male predominance (23 males, 11 females). Burn mechanisms included primarily scalds (n=20) and flame (n=12), of which 8 involved accelerants. Most injuries occurred at home (n=27). The average total body surface area (TBSA) affected was 29.9% (range 0.2-90, SD 20.3), and 13 patients (39.4%) sustained full-thickness burns. Burn size overestimation by referring centres occurred in 25.7% of cases and underestimation in 20% of cases. Commonly affected regions included the trunk (n=27), lower limbs (n=27), upper limbs (n=25), and face (n=24). Inhalation injuries were identified in 4 cases, and 3 patients were admitted with toxic shock syndrome. Average PICU stay was 251 hours, with 17 patients (51.5%) requiring mechanical ventilation (mean duration: 241 hours). Average hospital admission was 48 days. Total fluid volume exceeded Parkland formula calculations for 66.7% of patients. Fluid overload was reported in 3 cases, low urine output in 4 cases, and one death was recorded during the study period.
Conclusion:
PICU admissions for paediatric burns are infrequent but involve significant injury severity and resource use. Early identification and specialised care remain critical to improving outcomes.