The historical evolution, current status, and prospective development of pediatric critical care.

This article describes the multiple historic origins of pediatric critical care medicine and the evolution of the subspecialty, from the late 1950s with the first units dedicated to the care of critically ill and injured infants and children, to the present status as a recognized medical subspecialty. Also discussed are current major issues and future challenges that flow from both this historic background and a commitment to critically ill children. Presented are specific considerations for physicians in this subspecialty to address as they plan for the future.