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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/12 10:05:06」(JST)
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"PICU" redirects here. PICU may also refer to Psychiatric Intensive Care Unit.
A pediatric intensive care unit (also paediatric), usually abbreviated to PICU , is an area within a hospital specializing in the care of critically ill infants, children, and teenagers. A PICU is typically directed by one or more pediatric intensivists or PICU consultants[1] and staffed by doctors, nurses, and respiratory therapists who are specially trained and experienced in pediatric intensive care. The unit may also have nurse practitioners, physician assistants, physiotherapists, social workers, child life specialists, and clerks on staff although this varies widely depending on geographic location. The ratio of professionals to patients is generally higher than in other areas of the hospital, reflecting the acuity of PICU patients and the risk of life-threatening complications.[2] Complex technology and equipment is often in use, particularly mechanical ventilators and patient monitoring systems. Consequently, PICUs have a larger operating budget than many other departments within the hospital.[3][4]
Contents
- 1 History
- 2 Levels of care
- 2.1 United States
- 2.1.1 Level 1
- 2.1.2 Level 2
- 3 See also
- 4 References
- 5 External links
History
Goran Haglund established the first pediatric intensive care unit, which he called a "pediatric emergency ward", in 1955.[5]
Infants were first kept intubated for long periods in the early 1960s.[6] Breathing tubes made out of polyvinyl chloride (PVC) allowed clinicians to avoid performing tracheostomy (surgically inserting a tube into the windpipe) in more children who required prolonged mechanical ventilation.[6]
Levels of care
United States
Level 1
Level I PICUs are variable in size, personnel, physical characteristics, and equipment, and that they differ in the types of specialized care (ie, care following transplantation or cardiac surgery) that they provide. Nurse-to-patient ratios range from 2 nurses to 1 patient to 1 nurse to 3 patients. Registered respiratory therapists are required to be assigned primarily to the Level I PICU in-house 24 hours per day.[7]
Level 2
Level II PICUs are smaller than level I PICUs and are able to care for less critical patients.
See also
- Intensive Care Unit
- Intensive Care Medicine
- Neonatal Intensive Care Unit
- Pediatrics
References
- ^ Frankel, Lorry R; DiCarlo, Joseph V (2003). "Pediatric Intensive Care". In Bernstein, Daniel; Shelov, Steven P. Pediatrics for Medical Students (2nd ed.). Philadelphia: Lippincott illiams & Wilkins. p. 541. ISBN 978-0-7817-2941-3.
- ^ Pronovost, PJ; Dang, D; Dorman, T et al. (September 2001). "Intensive Care Unit Nurse Staffing and the Risk for Complications after Abdominal Aortic Surgery". Effective Clinical Practice (American College of Physicians–American Society of Internal Medicine) 4 (5): 199–206. PMID 11685977. Retrieved 2009-01-08.
- ^ Moerer O; Plock E; Mgbor U et al. (June 2007). "A German national prevalence study on the cost of intensive care: an evaluation from 51 intensive care units". Critical Care (BioMed Central) 11 (3): R69. doi:10.1186/cc5952. PMC 2206435. PMID 17594475.
- ^ Morton, Neil S (1997). Paediatric Intensive Care. Oxford University Press. ISBN 978-0-19-262511-3.
- ^ Morton 1997: 3
- ^ a b Duke, Trevor; Kissoon, Niranjan;Van Der Voort, Edwin (2008). "Pediatric Intensive Care: a Global Perspective". In David G Nichols. Roger's Textbook of Pediatric Intensive Care (4th ed.). PA: Lippincott Williams & Wilkins. pp. 18–23. ISBN 978-0-7817-8275-3.
- ^ "Guidelines and levels of care for pediatric intensive care units. Committee on Hospital Care of the American Academy of Pediatrics and Pediatric Section of the Society of Critical Care Medicine". Pediatrics 92 (1): 166–75. July 1993. PMID 8516070.
External links
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Intensive care medicine
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- Health science
- Medicine
- Medical specialities
- Respiratory therapy
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| General terms |
- Intensive care unit (ICU)
- Neonatal intensive care unit (NICU)
- Pediatric intensive care unit (PICU)
- Coronary care unit (CCU)
- Critical illness insurance
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| Conditions |
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Organ system failure
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- Shock sequence
- SIRS
- Sepsis
- Severe sepsis
- Septic shock
- Multiple organ dysfunction syndrome
- Other shock
- Cardiogenic shock
- Distributive shock
- Anaphylaxis
- Obstructive shock
- Neurogenic shock
- Spinal shock
- Organ failure
- Acute renal failure
- Acute respiratory distress syndrome
- Acute liver failure
- Respiratory failure
- Multiple organ dysfunction syndrome
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Complications
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- Critical illness polyneuropathy / myopathy
- Critical illness–related corticosteroid insufficiency
- Decubitus ulcers
- Fungemia
- Stress hyperglycemia
- Stress ulcer
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Iatrogenesis
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- Methicillin-resistant Staphylococcus aureus
- Oxygen toxicity
- Refeeding syndrome
- Ventilator-associated lung injury
- Ventilator-associated pneumonia
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| Diagnosis |
- Arterial blood gas
- Catheter
- Arterial catheter
- Central venous catheter
- Pulmonary artery catheter
- Blood cultures
- Screening cultures
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| Life supporting treatments |
- Airway management
- Chest tube
- Dialysis
- Enteral feeding
- Goal-directed therapy
- Induced coma
- Mechanical ventilation
- Therapeutic hypothermia
- Total parenteral nutrition
- Tracheal intubation
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| Drugs |
- Analgesics
- Antibiotics
- Antithrombotics
- Inotropes
- Intravenous fluids
- Neuromuscular-blocking drugs
- Recombinant activated protein C
- Sedatives
- Stress ulcer prevention drugs
- Vasopressors
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| ICU scoring systems |
- APACHE II
- Glasgow Coma Scale
- PIM2
- SAPS II
- SAPS III
- SOFA
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| Physiology |
- Hemodynamics
- Hypotension
- Level of consciousness
- Acid-base imbalance
- Water-electrolyte imbalance
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| Organisations |
- Society of Critical Care Medicine
- Surviving Sepsis Campaign
- European Society of Paediatric and Neonatal Intensive Care
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| Related specialties |
- Anesthesia
- Cardiology
- Internal medicine
- Neurology
- Pediatrics
- Pulmonology
- Surgery
- Traumatology
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UpToDate Contents
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English Journal
- Evolution of haemodynamics and outcome of fluid-refractory septic shock in children.
- Deep A, Goonasekera CD, Wang Y, Brierley J.SourcePaediatric Intensive Care Unit, King's College Hospital, Denmark Hill, London, SE5 9RS, UK, akash.deep@nhs.net.
- Intensive care medicine.Intensive Care Med.2013 Sep;39(9):1602-9. doi: 10.1007/s00134-013-3003-z. Epub 2013 Jun 28.
- BACKGROUND: Maintaining threshold values of cardiac output (CO) and systemic vascular resistance (SVR) when used as part of the American College of Critical Care Medicine (ACCM) haemodynamic protocol improves the outcomes in paediatric septic shock.OBJECTIVE: We observed the evolution of CO and SVR
- PMID 23812341
- Optimal sedation in pediatric intensive care patients: a systematic review.
- Vet NJ, Ista E, de Wildt SN, van Dijk M, Tibboel D, de Hoog M.SourceIntensive Care, Erasmus MC, Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands, n.vet@erasmusmc.nl.
- Intensive care medicine.Intensive Care Med.2013 Sep;39(9):1524-34. doi: 10.1007/s00134-013-2971-3. Epub 2013 Jun 19.
- PURPOSE: Sedatives administered to critically ill children should be titrated to effect, because both under- and oversedation may have negative effects. We conducted a systematic review to examine reported incidences of under-, optimal, and oversedation in critically ill children receiving intensive
- PMID 23778830
- Acute administration of alprazolam, a benzodiazepine activating GABA receptors, inhibits cortisol secretion in patients with subclinical but not overt Cushing's syndrome.
- Giordano R, Berardelli R, Karamouzis I, D'Angelo V, Picu A, Zichi C, Fussotto B, Manzo M, Mengozzi G, Ghigo E, Arvat E.SourceDepartment of Clinical and Biological Sciences, University of Turin, Orbassano, Italy, roberta.giordano@unito.it.
- Pituitary.Pituitary.2013 Sep;16(3):363-9. doi: 10.1007/s11102-012-0433-5.
- The purpose of this study is to verify whether acute pre-treatment with alprazolam (ALP), a benzodiazepine that inhibits HPA secretion in normal subjects, could better characterize patients with subclinical Cushing's syndrome (SCS) than the 1-mg dexamethasone test (DST). In 22 patients with SCS, 10
- PMID 22983690
Japanese Journal
- PICUにおける看護師教育としてのシミュレーション (特集 小児看護におけるシミュレーション教育)
- ER型救急外来における重症小児患者診療の実情と課題
- 志賀 一博,木部 哲也,岡田 眞人 [他]
- 日本小児科学会雑誌 = The journal of the Japan Pediatric Society 117(10), 1652-1657, 2013-10
- NAID 40019833448
Related Links
- デジタル大辞泉 - PICUの用語解説 - 《Pediatric Intensive Care Unit》小児の大けがや、緊急を要する脳・内臓などの疾患に対応できる設備と医療スタッフを備えた集中治療室。小児集中治療室。小児集中治療管理室。
- 東京大学医学部附属病院 新生児集中治療室 PICUのホームページです。東大病院小児科は主に心臓病などの重い病気のお子さんの治療を行っています。
Related Pictures
★リンクテーブル★
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- 英
- perinatal intensive care unit, PICU
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- 同
- pediatric intensive care units