Chronic Illness in Pediatric Critical Care

Area of Science:

• Pediatric critical care medicine
• Complex pediatric chronic conditions

Background:

• Children and Youth with Special Healthcare Needs (CYSHCN), children with medical complexity (CMC), and children with chronic, critical illness (CCI) are vulnerable populations.
• These pediatric groups have diverse underlying conditions and varying medical needs.
• Intercurrent illness or surgery often necessitates acute care in the pediatric intensive care unit (PICU).

Purpose of the Study:

• To review epidemiologic trends of chronic illness in the PICU.
• To differentiate these complex pediatric populations from those without significant baseline needs.
• To explore care models for acute and chronic illness intersection and future PICU provider roles.

Main Methods:

• Literature review of epidemiologic trends.
• Comparative analysis of patient populations.
• Synthesis of existing care models.
• Discussion of future considerations for PICU providers.

Main Results:

• Increasing prevalence of chronic conditions in PICU populations.
• Distinct needs of CYSHCN, CMC, and CCI compared to general pediatric ICU patients.
• Identification of care gaps and opportunities for specialized interventions.
• Emerging models of care integrating acute and chronic care management.

Conclusions:

• PICU care for CYSHCN, CMC, and CCI requires specialized approaches.
• Future PICU provider roles should encompass enhanced chronic care management.
• Optimizing outcomes necessitates tailored care models and interdisciplinary collaboration.
• Further research is needed to refine best practices for these complex pediatric populations.