Biarent D, Otte F, Fonteyne C, Khalil T
Unité de Soins Intensifs Pédiatriques, Hôpital Universitaire des Enfants Reine Fabiola, ULB.
Rev Med Brux. 2006;27 Spec No:Sp39-43.
Paediatric intensive care is born 40 years ago. It has been shown that admission of critically ill children in intensive care (ICU) where no paediatric intensivists worked increased significantly the mortality and the length of stay. The recognition of Paediatric Intensive Care (PICU) does not exist in Belgium and children are admitted in both adult and paediatric intensive care units. It is mandatory to recognise the PICU specificity and the usefulness of a fellowship in paediatric intensive care. Development of molecular biology and genetics will permit in the near future to understand reversible and irreversible cellular processes of the majority of problems responsible for mortality in critical care and to allow the development of new diagnostic and therapeutic techniques. Rapid development of information will permit the creation of multicenter databases including all PICU's data. The final goal is an intelligent tool for making decision process. Telemedecine is born which permits a virtual consultation of the patient. Technological progress must not impair the wellbeing of the child and its family. The PICU of the future must be "parents admitted". PICU profile is progressively changing, the way of taking care of the critically ill child and its family is also changing and improving. An ethical reflexion among the health care providers' team and a dialogue with parents will blossom.
儿科重症监护诞生于40年前。研究表明，将危重症儿童收治到没有儿科重症医学专家工作的重症监护病房（ICU）会显著增加死亡率和住院时间。比利时不存在对儿科重症监护（PICU）的认可，儿童被收治到成人和儿科重症监护病房。必须认识到PICU的特殊性以及儿科重症监护专科培训的有用性。分子生物学和遗传学的发展将在不久的将来使人们能够理解导致重症监护中大多数死亡问题的可逆和不可逆细胞过程，并推动新诊断和治疗技术的发展。信息的快速发展将允许创建包含所有PICU数据的多中心数据库。最终目标是打造一个用于决策过程的智能工具。远程医疗应运而生，它允许对患者进行虚拟会诊。技术进步绝不能损害儿童及其家庭的福祉。未来的PICU必须“允许家长陪同”。PICU的情况正在逐步变化，照顾危重症儿童及其家庭的方式也在不断变化和改进。医疗团队之间的伦理思考以及与家长的对话将会蓬勃开展。
