Pediatric Intensive Care provides organ-specific support to critically ill children with a very broad range of diagnoses. Its development over the last two decades has transformed outcomes for these children in high-, middle- and low-income settings. Scientific advances have led to improved outcomes over time, with pediatric intensive care unit (PICU) mortality approaching 3% in highly-resourced pediatric intensive care settings. However, this success has come with consequences. The survivors of critical illness often have long term neurodevelopmental morbidity and technology dependence. In addition, the availability of novel therapies for previously fatal diseases and the availability in many countries of long-term ventilator support has meant that many more technology-dependent children are surviving and being admitted to PICU. 50% of PICU bed days in the UK, for example, are used by 10% of admissions. There is, therefore, an urgent need to enhance our understanding of disease pathogenesis and of innovative approaches to improved diagnosis and treatment. This call for articles also seeks to discover new approaches to multidisciplinary clinical care of children in the hospital setting while appreciating the need for disease prevention and the value of post-hospital care of critically ill children.
The Journal is keenly interested in research articles that report findings from randomized controlled trials, trial protocols, and observational studies. Review articles on important issues in the care of critically ill children requiring PICU care will also be considered. We welcome articles focused on basic and translational science, clinical care, and health services and systems research. To support this call for articles, a wide range of articles will be supported within the pediatric critical care medicine collection, illustrating with sepsis, an important cause of child mortality and morbidity worldwide:
Basic and translational science
- Pathogenesis of sepsis and resultant organ dysfunction.
- Precision medicine, including genomic medicine.
- Systems biology approaches to the care of sepsis.
- Immunomodulation in sepsis.
- Endotypes in sepsis.
- Multiple organ dysfunction syndrome: pathogenesis, epidemiology, and measurement of severity.
- Pre-hospital care: Timeliness of definitive care including transport and inter-hospital transfer, triage.
- Hospital care: Novel treatment approaches and therapeutic modalities, organ-supportive technology, resuscitation, modulation of the inflammatory response, monitoring technology, quality-of-care metrics and performance improvement, and innovative multidisciplinary approaches to care.
- Outcomes of care: Mortality, post-discharge functional status, health-related quality of life, and morbidity.
- Post-hospital care: Post-intensive care syndrome, and chronic critical illness including technology-dependence.
Health services and systems research
- Healthcare resource use, costs of care, economic burden of care, cost-benefit analyses, caregiver and family burden.
- Novel approaches to system-wide care of children with sepsis.
- Epidemiology: Novel approaches including big data analysis, data science, and machine learning methods.