Murphy Salem Sinead, Graham Robert J
Department of Anesthesiology, Boston Children's Hospital, Critical Care and Pain Medicine and Harvard Medical School, Boston, MA, United States.
Front Pediatr. 2021 May 14;9:686206. doi: 10.3389/fped.2021.686206. eCollection 2021.
Children and Youth with Special Healthcare Needs (CYSHCN), children with medical complexity (CMC), and children with chronic, critical illness (CCI) represent pediatric populations with varying degrees of medical dependance and vulnerability. These populations are heterogeneous in underlying conditions, congenital and acquired, as well as intensity of baseline medical needs. In times of intercurrent illness or perioperative management, these patients often require acute care services in the pediatric intensive care (PICU) setting. This review describes epidemiologic trends in chronic illness in the PICU setting, differentiates these populations from those without significant baseline medical requirements, reviews models of care designed to address the intersection of acute and chronic illness, and posits considerations for future roles of PICU providers to optimize the care and outcomes of these children and their families.
有特殊医疗需求的儿童和青少年（CYSHCN）、患有复杂疾病的儿童（CMC）以及患有慢性危重症的儿童（CCI）代表了具有不同程度医疗依赖和脆弱性的儿科人群。这些人群在潜在疾病（先天性和后天性）以及基线医疗需求强度方面存在异质性。在并发疾病期间或围手术期管理时，这些患者通常需要在儿科重症监护病房（PICU）接受急性护理服务。本综述描述了PICU环境中慢性病的流行病学趋势，将这些人群与那些没有显著基线医疗需求的人群区分开来，回顾了旨在应对急性和慢性疾病交叉问题的护理模式，并提出了关于PICU提供者未来角色的考虑因素，以优化这些儿童及其家庭的护理和结局。
