Current challenges in the organization of pediatric resuscitation: a review

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Abstract

This paper presents a narrative review of Russian and international studies on the current problems in the organization of pediatric resuscitation and potential solutions. We characterize the causes of acute and chronic critical illnesses in children that require admission to the intensive care unit. Significant progress has been made in pediatric critical care: whereas the previous goal was to reduce mortality in pediatric patients, the current priority is improving the quality of life of surviving children and their families.

However, several key issues remain debated: optimal indications for extracorporeal cardiopulmonary resuscitation, choice of infusion solutions and pharmacotherapy in neonatal resuscitation, and standardization of nutritional support and sedation protocols. The number of children with chronic critical illnesses has increased; their prolonged ICU stays are associated with higher healthcare costs and worse outcomes. A systematic, multidisciplinary approach, supported by international and national clinical guidelines and diagnostic algorithms, is essential. Synthesis of the available data helps identify priority areas for further research on the organization of pediatric critical care. This review may be of interest to critical care physicians, pediatricians, and healthcare administrators.

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About the authors

Manuel M. Megeryan

Podolsk Children's Hospital

Email: pdgb-work@mail.ru
ORCID iD: 0000-0002-2062-8060
Russian Federation, Podolsk

Aleksey Yu. Abramov

Peoples' Friendship University of Russia

Email: abramov-au@rudn.ru
ORCID iD: 0000-0001-7178-1260
SPIN-code: 1235-6273

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Elena A. Degtyareva

Podolsk Children's Hospital; Peoples' Friendship University of Russia

Author for correspondence.
Email: dgp48@yandex.ru
ORCID iD: 0000-0003-4865-732X
SPIN-code: 3606-5570

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Podolsk; Moscow

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