Abstract
The neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) subcommittee of the Japanese Society of Critical Care Medicine examined the results of a nationwide questionnaires and concluded that there are only 16 PICUs with separate nursing units in Japan. They also found that the number of PICUs in Japan has not increased for several years. PICUs have become widespread in North America and Europe, ever since it was recognized in the 1970s that pediatric intensive care specialists could decrease the mortality rate of severely sick children. Nevertheless, the efficacy of PICUs has not yet been demonstrated in Japan. To illustrate the efficacy of PICUs in Japan, we compared the total pediatric mortality rates and the injury-induced pediatric mortality rates between Japanese prefectures with PICUs and those without PICUs. Then, the necessary number of PICU beds in Japan was estimated, based on data from North America and Europe. Finally, we estimated the number of 1- to 4-year-old children who could be saved using the newly planned nationwide PICU system in Japan, since the present mortality rate of 1- to 4-year-old children in Japan is significantly higher than that of other developed countries. Although no significant difference in the total pediatric mortality rates, including those for chronic diseases, was observed between prefectures with and prefectures without PICUs, the average injury-induced pediatric mortality rate was significantly lower in the prefectures with PICUs than in those without PICUs. This is the first evidence showing the efficacy of PICUs in Japan. The necessary number of PICU beds has been estimated to be about 500 beds in Japan, since 1 PICU bed is necessary per 40,000 children in Japan-based on data from North America and Europe. By adopting the newly planned nationwide PICU system in Japan, about 500 children between the ages of 1 and 4 years old are expected to be saved annually. The efficacy of PICUs was demonstrated in this study. The nationwide PICU system should be included in the newly planned nationwide pediatric emergency medicine system being developed by the Japanese Society of Pediatrics.
