Pediatric Intensive Care Unit Admission and Outcomes in Trisomy 21 Patients: A Retrospective Analysis

Abstract

Children with Trisomy 21 (Down syndrome, T21) frequently require intensive care due to multiple comorbidities. This retrospective study evaluated the reasons for pediatric intensive care unit (PICU) admission, clinical features, and mortality factors in genetically confirmed T21 patients admitted between January 2023 and December 2024. Thirty-seven patients were included (64.9% male; median age = 2.65 years). Respiratory failure was the leading cause of admission (81%), followed by sepsis (5.4%). The overall mortality rate was 13.5% (n = 5). All nonsurvivors required invasive mechanical ventilation and inotropic support. They more frequently exhibited tachycardia, arrhythmia, hypotension, pleural effusion, cytopenias, renal dysfunction, and electrolyte disturbances. Procalcitonin and lactate dehydrogenase (LDH) levels were also higher among nonsurvivors. In this single-center retrospective series, the primary reason for PICU admission among children with T21 was respiratory failure, while mortality was associated with mechanical ventilation, inotropic support, and renal/electrolyte disturbances. Larger, multicenter, and prospective studies are needed to ensure generalizability.