Pediatric Critical Care: Grand Challenges for a Glowing Future

Pediatric critical care is a relatively new field, tracing its origins to the polio epidemics that killed large numbers of children, birthed by ongoing efforts in pediatric anesthesiology and neonatology, and nourished by parallel advances in pediatric pulmonology, cardiology, nephrology, adult critical care, general, cardiothoracic, neurosurgery, or other fields. Although not many pediatric intensive care units (PICUs) existed before 1980 (Table 1) (1– 3), they now occupy a central position in the care of all hospitalized children and in their improved survival from all types of medical/surgical conditions. Despite an overwhelmingly clinical focus and limited avenues for disseminating research, the numbers of PICU-related publications have increased steadily over the past 20 years, currently hovering around 5000 reports per year. Pediatric Critical Care, a section in the journal Frontiers in Pediatrics, seeks to disseminate the highest quality scholarly activity in this field, thus closing gaps between clinical practices and the highlevel evidence supporting these practices. The four grand challenges include: