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Pediatric cardiac intensivists in low-middle-income countries - necessity or dispensable luxury?

Parvathi Unninayar Iyer1, Krishna Subramony Iyer1

  • 1Department of Pediatric & Congenital Heart Surgery, Fortis Escorts Heart Institute, Okhla Road, New Delhi, 110025 India.

Indian Journal of Thoracic and Cardiovascular Surgery
|May 26, 2025
PubMed

Insights

Pediatric cardiac intensive care (PCIC) is essential for congenital heart disease (CHD) patients, even in low-resource settings. This study examines the feasibility and necessity of PCIC in low- and middle-income countries (LMICs).

Area of Science:

  • Pediatric critical care medicine
  • Congenital heart disease management
  • Global health equity in specialized care

Background:

  • Pediatric cardiac intensive care (PCIC) is a recognized specialty in developed nations for congenital heart disease (CHD) and surgery (CHS).
  • Significant challenges exist in delivering CHD care in low- and middle-income countries (LMICs), particularly regarding resources for PCIC units and trained personnel.
  • The disparity in specialized pediatric cardiac care between high-income and low-resource settings is a critical global health issue.

Purpose of the Study:

  • To explore the feasibility and necessity of establishing reliable pediatric cardiac intensive care (PCIC) in low- and middle-income countries (LMICs).
  • To assess whether PCIC is dispensable or remains a critical component of congenital heart disease (CHD) care in resource-limited environments.
  • To examine the current status and challenges of PCIC in resource-constrained settings.

Main Methods:

  • Literature review and analysis of existing data on PCIC in LMICs.
  • Exploration of resource availability and infrastructure requirements for PCIC units.
  • Discussion of the role of pediatric intensivists and specialized training in LMICs.

Main Results:

  • PCIC is well-established in developed countries but faces significant resource and personnel challenges in LMICs.
  • The need for specialized care for congenital heart disease (CHD) surgery (CHS) is universal, irrespective of economic status.
  • Current PCIC initiatives in LMICs are often limited by funding, infrastructure, and trained workforce.

Conclusions:

  • Reliable pediatric cardiac intensive care (PCIC) is a necessity, not dispensable, for optimal congenital heart disease (CHD) management in low- and middle-income countries (LMICs).
  • Addressing resource limitations and investing in training are crucial for developing sustainable PCIC in LMICs.
  • Global collaboration and innovative strategies are required to bridge the gap in specialized pediatric cardiac care.

Keywords:
CHD surgeryLMICPediatric cardiac intensive care

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