A research definition and framework for acute paediatric critical illness across resource-variable settings: a...

Area of Science:

• Global Health
• Paediatric Critical Care
• Clinical Definitions

Background:

• The global burden of acute paediatric critical illness is poorly understood due to a lack of a standardized definition.
• Existing definitions often depend on local healthcare capacity, limiting global research comparability.

Purpose of the Study:

• To develop an evidence-informed, consensus-based definition and framework for acute paediatric critical illness (DEFCRIT).
• To establish a universal standard for identifying and researching critically ill children worldwide, irrespective of resource settings.

Main Methods:

• A scoping review of 29 studies identified key concepts.
• An international expert panel (n=24) refined concepts.
• A modified Delphi process with 109 multidisciplinary experts achieved consensus on the final definition and framework.

Main Results:

• Consensus was reached on eight essential attributes and 28 statements for DEFCRIT.
• The final definition encompasses physiological instability or clinical support requirements to prevent deterioration or death in children.
• An expert retention rate of 89% was achieved over two Delphi rounds.

Conclusions:

• The proposed DEFCRIT provides conceptual clarity for a unified global research approach to paediatric critical illness.
• Future research will focus on validating DEFCRIT and developing guidelines for its implementation in diverse settings.