Biban P
Neonatal and Paediatric Intensive Care Unit, Azienda Ospedaliera-Universitaria Integrata, Verona, Italy.
Minerva Pediatr. 2010 Jun;62(3 Suppl 1):129-31.
Neonatal and paediatric intensive care units (NICUs and PICUs) are growing in number, size and complexity, and each unit is staffed by a highly specialized group of doctors and nurses. Indeed, practitioners within these subspecialties acquire specific cognitive and procedural skills garnered from focused multidisciplinary training, as well as from experience with critically ill newborns and children. Although the NICUs and PICUs share many commonalities, the relationship between caregivers in the neonatal and paediatric critical care units often is characterized by rivalry and antagonism rather than by cooperation. In addition, as in the Italian scenario, the scientific and professional background in most cases differ between neonatologists, predominantly coming from a paediatric-oriented curriculum, and paediatric intensivists, mainly affiliated to adult anaesthesia and intensive care residency programs. However, in some circumstances, particularly when dealing with smaller patients, the limits between these two distinct disciplines appear quite vague, and undoubtedly many clinicians have the perception that the two branches, namely neonatology and paediatric anaesthesia and intensive care, would get a mutual benefit by a stronger collaboration and cross-contamination. Indeed, in some situations, such as shortage of PICU beds or patients not easily transferable to a PICU, neonatologists are occasionally called to take care of critically ill infants and young children. However, these "paediatric" patients may often present with complex pathologies which the neonatologist may not be familiar with. This condition raises important issues about the advisability to provide specific education and training in paediatric intensive care also to neonatologists, according to local needs and caregivers' expectations.
新生儿重症监护病房和儿科重症监护病房（NICU和PICU）在数量、规模和复杂性方面都在不断增长，每个病房都配备了一批高度专业化的医生和护士。事实上，这些亚专业领域的从业者通过专注的多学科培训以及对危重新生儿和儿童的护理经验，获得了特定的认知和操作技能。尽管NICU和PICU有许多共同之处，但新生儿重症监护病房和儿科重症监护病房的医护人员之间的关系往往以竞争和对抗而非合作为特征。此外，就像在意大利的情况一样，在大多数情况下，新生儿科医生（主要来自以儿科为导向的课程）和儿科重症监护医生（主要隶属于成人麻醉和重症监护住院医师项目）的科学和专业背景有所不同。然而，在某些情况下，特别是在处理较小的患者时，这两个不同学科之间的界限显得相当模糊，毫无疑问，许多临床医生认为，新生儿科和儿科麻醉与重症监护这两个分支通过更强有力的合作和交叉融合将互利共赢。的确，在某些情况下，比如PICU床位短缺或患者不易转至PICU时，新生儿科医生偶尔会被要求照顾危重症婴幼儿。然而，这些“儿科”患者可能常常患有新生儿科医生并不熟悉的复杂病症。根据当地需求和医护人员的期望，这种情况引发了关于是否也应为新生儿科医生提供儿科重症监护方面的特定教育和培训的重要问题。
