Updated Recommendations, Levels of Care Categorized for Pediatric ICUs

Three levels of care include community-based, tertiary, and quaternary or specialized PICUs

THURSDAY, Sept. 5, 2019 (HealthDay News) -- Three levels of care are recommended for pediatric intensive care unit (PICU) patients, according to a policy statement published online Sept. 4 in Pediatrics.

Benson S. Hsu, M.D., from the Sanford School of Medicine at the University of South Dakota in Vermillion, and colleagues updated the 2004 guidelines and levels of care for PICUs. Outcome and quality research relating to admission, transfer, and discharge criteria and literature relating to PICU levels of care were reviewed.

The researchers note that critically ill or injured pediatric patients should receive care in a child- and family-centered environment by a multidisciplinary care team. Community medical center PICUs play an important role in health care systems and provide a broad range of services and resources; previous guidelines classified these centers as level II PICUs. Tertiary PICUs provide advanced care for many medical and surgical illnesses; these were previously categorized as level I PICUs. Tertiary PICUs should provide advanced ventilator support, but are not expected to provide extracorporeal membrane oxygenation support. A quaternary or specialized PICU provides regional care and serves a large population or catchment area; these centers can provide comprehensive care for all complex patients and diagnosis-specific care for select patient populations.

"These three levels of PICUs will provide the best possible care to the critically ill pediatric patient in an environment that is most appropriate for the medical or surgical issues facing the child and his/her family," a coauthor said in a statement.

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