CHEST Guidelines-Where-PICU-Beds-Are-Lacking,-the-Model-of-“

Where-PICU-Beds-Are-Lacking,-the-Model-of-“

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The document is a correspondence between healthcare professionals discussing the management of critically ill infants and toddlers in the context of limited Pediatric Intensive Care Unit (PICU) capacity, particularly during public health emergencies such as the COVID-19 pandemic. In areas where PICU beds are limited, the authors propose creating "extended NICUs" (Neonatal Intensive Care Units) for treating infants and small toddlers. This model relies on training NICU staff in pediatric critical care to handle the typical diseases of this age group, often related to perinatal conditions like congenital disorders or premature birth complications. The proposal aims to provide better care for small children as neonatologists tend to have more expertise in dealing with such conditions than adult intensivists.<br /><br />The authors also address the need for flexible admission criteria based on patient age to efficiently manage healthcare resources during emergencies when demand exceeds available PICU beds. The letter suggests that while adult ICUs can temporarily support pediatric care, children generally receive better outcomes in age-appropriate care settings when possible. The implementation of teleconsultation technology is suggested as an additional support measure to address bed shortages.<br /><br />Additionally, the discussion highlights that the proposed "extended NICU" model is contingent on healthcare organizational structures and training differences across countries. The original article comments emphasize the necessity of preparedness for future health emergencies that may affect children more extensively, implying that collaboration between neonatal, pediatric, and adult care units could be crucial to sustaining adequate healthcare systems.

Keywords

Pediatric Intensive Care

Critically Ill Infants

Extended NICUs

COVID-19 Pandemic

Neonatal Intensive Care

Teleconsultation Technology

Congenital Disorders

Premature Birth Complications

Healthcare Resource Management

Emergency Preparedness