Executive Summary: Criteria for Critical Care of Infants and Children: PICU Admission, Discharge, and Triage Practice Statement and Levels of Care Guidance.

Benson S Hsu, Vanessa Hill, Lorry R Frankel, Timothy S Yeh, Shari Simone, Marjorie J Arca, Jorge A Coss-Bu, Mary E Fallat, Jason Foland, Samir Gadepalli, Michael O Gayle, Lori A Harmon, Christa A Joseph, Aaron D Kessel, Niranjan Kissoon, Michele Moss, Mohan R Mysore, Michele E Papo, Kari L Rajzer-Wakeham, Tom B Rice, David L Rosenberg, Martin K Wakeham, Edward E Conway, Michael S D Agus

Journal: Pediatrics 2020;144(4):e20192433

PMID: 31488695

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Abstract

This is an executive summary of the 2019 update of the 2004 guidelines and levels of care for PICU. Since previous guidelines, there has been a tremendous transformation of Pediatric Critical Care Medicine with advancements in pediatric cardiovascular medicine, transplant, neurology, trauma, and oncology as well as improvements of care in general PICUs. This has led to the evolution of resources and training in the provision of care through the PICU. Outcome and quality research related to admission, transfer, and discharge criteria as well as literature regarding PICU levels of care to include volume, staffing, and structure were reviewed and included in this statement as appropriate. Consequently, the purposes of this significant update are to address the transformation of the field and codify a revised set of guidelines that will enable hospitals, institutions, and individuals in developing the appropriate PICU for their community needs. The target audiences of the practice statement and guidance are broad and include critical care professionals; pediatricians; pediatric subspecialists; pediatric surgeons; pediatric surgical subspecialists; pediatric imaging physicians; and other members of the patient care team such as nurses, therapists, dieticians, pharmacists, social workers, care coordinators, and hospital administrators who make daily administrative and clinical decisions in all PICU levels of care.

Address: Pediatric Critical Care, Sanford School of Medicine, University of South Dakota, Vermillion, South Dakota.; Hospital Medicine, Baylor College of Medicine and Children's Hospital of San Antonio, San Antonio, Texas.; Department of Pediatrics and Critical Care Services, California Pacific Medical Center, San Francisco, California.; Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey.; PICU, Medical Center, University of Maryland, Baltimore, Maryland.; Divisions of Pediatric Surgery and.; Pediatrics and Critical Care Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.; Division of Pediatric Surgery, University of Louisville and Norton Children's Hospital, Louisville, Kentucky.; Pediatric Intensive Care, Studer Family Children's Hospital, Ascension Sacred Heart, Pensacola, Florida.; Division of Pediatric Surgery, University of Michigan, Ann Arbor, Michigan.; Pediatric Intensive Care, Wolfson Children's Hospital, Jacksonville, Florida.; Department of Quality, Society of Critical Care Medicine, Mount Prospect, Illinois.; Pediatric Intensive Care, Children's Hospital Oakland, Oakland, California.; Pediatric Critical Care Medicine, Cohen Children's Medical Center, New Hyde Park, New York.; Medical Affairs, British Columbia Children's Hospital, Vancouver, Canada.; Pediatric Critical Care Medicine, Arkansas Children's Hospital, Little Rock, Arkansas.; Pediatrics, Critical Care Medicine, College of Medicine, Medical Center, University of Nebraska, Omaha, Nebraska.; PICU, Medical City Children's Hospital, Dallas, Texas.; Pediatric Critical Care Medicine, Children's Hospital of Wisconsin, Wauwatosa, Wisconsin.; Pediatric Critical Care Medicine.; Pediatrics and Pediatric Intensive Care, Grand Strand Medical Center, Myrtle Beach, South Carolina.; Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, Wisconsin.; Pediatric Critical Care Medicine.; Pediatrics and Pediatric Critical Care Medicine, Jacobi Medical Center, the Bronx, New York; and.; Division of Medical Critical Care, Boston Children's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts.

DOI: 10.1542/peds.2019-2433

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MeSH Terms: Advisory Committees, Child, Critical Care, Delphi Technique, Humans, Infant, Intensive Care Units, Pediatric, Patient Admission, Patient Discharge, Pediatrics, Triage