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Chronic Illness in Pediatric Critical Care
Sinead Murphy Salem1, Robert J Graham1
1Department of Anesthesiology, Boston Children's Hospital, Critical Care and Pain Medicine and Harvard Medical School, Boston, MA, United States.
Frontiers in Pediatrics
|May 31, 2021
Summary
Children with special healthcare needs, medical complexity, or chronic critical illness often require intensive pediatric care. This review examines their care in the PICU and future provider roles.
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.
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