Establishing Pediatric Cardiac Intensive Care Unit in a Low Resource Setting: Bangladesh Perspective and Dhaka Shishu (Children) Hospital Paediatric Cardiac Intensive Care Unit Model

Abstract

Abstract

Comparing Two Models of Pediatric Cardiac Care Establishment in a Developing Country

“…[6] In many developed countries, pediatric cardiac intensive care has transformed into a separate field with specialized programs in practice. [2] On the other hand, in developing nations, pediatric cardiac surgery is an ongoing challenge, and current cardiac intensive care models cannot be implemented because of severe resource constraints that must be overcome. It is challenging to put into practice advanced methods to address the surgical needs of a substantial percentage of children with congenital heart defects while dealing with severe financial constraints and maintaining quality with the context of constant job turnover of equipped medical, nursing, and other paramedical personnel.…”

“…With the rapidly growing specialty of pediatric cardiac intensive care, the demands of children with congenital heart disease (CHD) are being met. [1,2] Intensive care unit (ICU) workflow with multidisciplinary teams is well known to result in better outcomes. [2,3] At present, the collaboration between surgery and cardiac critical care has resulted in drastically improved results, with ICU mortality estimated in single-digit percentages.…”

“…[1,2] Intensive care unit (ICU) workflow with multidisciplinary teams is well known to result in better outcomes. [2,3] At present, the collaboration between surgery and cardiac critical care has resulted in drastically improved results, with ICU mortality estimated in single-digit percentages. [4] For the perioperative management of these critically ill children, organized pediatric cardiac ICUs have become essential because of the growing difficulty of congenital heart repairs in the modern era and the special needs for managing children following cardiac surgery.…”

“…[1] Furthermore, with the wider availability of accurate diagnostics and the improving potential for total anatomic repair, an increasing number of children are undergoing cardiac surgery for congenital heart disorders. [2] Consequently, there is a growing need for specialists to provide dedicated and high-quality intensive care to these critical patient groups.…”

The Need for Specialized Pediatric Cardiac Critical Care Training Program in Limited Resource Settings

“…Due to limited infrastructure, funding, and human resources in low- and middle-income countries, a dedicated pediatric cardiac intensive care is not widely available as compared to high-income countries. The cardiac services are provided by a multidisciplinary team including pediatric cardiologists, pediatric cardiac surgeons, intensivists, anesthesiologists, critical care nurses, respiratory therapists, and other allied health workers who are available to care for children after cardiac surgery ( 21 , 24 , 25 ).…”