Med Intensiva. 2011;35(6):328---330 www.elsevier.es/medintensiva EDITORIAL Towards the future in pediatric intensive care  Hacia el futuro en cuidados intensivos pediátricos E. Ocete Hita Servicio de Pediatría, Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Virgen de las Nieves, Granada, Spain Received 31 May 2011; accepted 3 June 2011 Even today, in 2011, pediatric intensive care medicine can be regarded as a ‘‘new’’ specialty with a promising future. No more than three decades have passed from the start of the development of specific techniques for vital signs support and control in children and the establishment of differentiated wards for such patients, to structuring of the discipline as such. However, in this period of time there has been a biotechnological revolution of such magnitude that pediatric intensive care has largely experienced a change in its concepts; new methodologies have been adopted; and those who work in this field must constantly keep themselves abreast of the new developments. Good examples of these changes are the increase in num- ber, and especially in the quality of the care units dedicated to critically ill children; the typification of techniques and systems conceived for pediatric patients; the growth in con- trasted literature; the inclusion in the new training plans of topics dedicated to vital emergency care in pediatrics; and the quality and quantity of specific training programs in pediatric intensive care. There is a clear symbiosis between adult and pediatric intensive care. Pediatric Intensive Care Units (PICUs) have progressively absorbed the experience of adult ICUs, mod- ifying and adapting protocols, adjusting techniques and designing materials appropriate for the broad range of ages, sizes and weights found in the pediatric population. How- ever, it presently can also be affirmed that through ‘‘our children’’, adult ICUs have developed new and improved ventilation techniques such as the use of high-frequency ventilation; noninvasive techniques for monitoring gases  Please cite this article as: Ocete Hita E. Hacia el futuro en cuidados intensivos pediátricos. Med Intensiva. 2011;35:328---30. E-mail address: estherocete@ugr.es and pressures (trans-fontanelle intracranial pressure, facil- itating the development of optic fiber sensors); new drug formulations such as exogenous surfactant. In pediatric intensive care medicine, the predominance of infectious and metabolic diseases (dehydration), acute cardiological and respiratory disorders, and general, cardio- vascular and neurological pediatric surgery postoperative care, etc., has given way to disorders demanding more complex patient care such as severe head injuries, solid organ transplants, and alterations secondary to immune suppression. 1 This situation is illustrated in the articles on head injuries that the group of the Maternal-Children’s Uni- versity Hospital Complex in Las Palmas de Gran Canaria (Canary Islands, Spain) have published in this number of Medicina Intensiva. 2,3 At present, with the disappearance of many of the above- mentioned illnesses and the improvements in primary care, the criteria for the hospital admission of pediatric patients in general and for admission to the PICU have changed completely, with new demands for the care of critically ill children. Care activities with children amenable to intensive care entails a series of aspects: (a) integral clinical assessment of the patient, viewing the case as a whole rather than as the failure of a given organ; (b) application of a series of spe- cific diagnostic and therapeutic techniques and procedures to define the acute problem involved, its repercussions, and to adopt the opportune management measures; and (c) continuity in the follow-up of the disease process, since the course of the condition varies constantly, and adequate adaptation of the therapeutic norms represents a system- atic task in the PICU. All these aspects cause the medical professionals to need profound pediatric knowledge and to master a series of technological skills, with the capacity to observe, and the ability to take urgent decisions. 2173-5727/$ – see front matter © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved. Documento descargado de http://www.elsevier.es el 09/08/2017. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato.