Academic Journal
Integrating Paediatric Intermediate Care Units Into Tiered Care Systems: A Narrative Review and Italian Perspective.
| Τίτλος: | Integrating Paediatric Intermediate Care Units Into Tiered Care Systems: A Narrative Review and Italian Perspective. |
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| Συγγραφείς: | Brisca G; Neonatal and Pediatric Intensive Care Unit, Intermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Pirlo D; Neonatal and Pediatric Intensive Care Unit, Intermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Romanengo M; Neonatal and Pediatric Intensive Care Unit, Intermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Moscatelli A; Neonatal and Pediatric Intensive Care Unit, Intermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy. |
| Πηγή: | Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2026 Sep; Vol. 115 (9), pp. 1872-1877. Date of Electronic Publication: 2026 May 28. |
| Τύπος έκδοσης: | Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: Norway NLM ID: 9205968 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1651-2227 (Electronic) Linking ISSN: 08035253 NLM ISO Abbreviation: Acta Paediatr Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2007- : Oslo : Wiley-Blackwell Original Publication: Oslo : Scandinavian University Press, c1992- |
| Ιατρικοί όροι (MeSH): | Intermediate Care Facilities*/organization & administration , Hospitals, Pediatric*/organization & administration, Humans ; Italy ; Child ; Pediatrics |
| Περίληψη: | Aim: Paediatric hospital care has become increasingly complex with many children requiring monitoring and support beyond general ward capabilities. This review evaluated the role of paediatric intermediate care units (PIMCUs) within tiered paediatric care systems, with a focus on organizational impact and implementation in Italy. Methods: We conducted a narrative review using PubMed, Embase, Scopus and the Cochrane Library up to 31 December 2025. Studies addressing PIMCUs were included, together with selected adult studies on organizational and economic aspects. The PIMCU model at the Gaslini Institute in Genoa, Italy, was also described. Results: PIMCUs provided intermediate care for children requiring enhanced monitoring and noninvasive support without full intensive care. Paediatric studies suggested improved patient allocation, reduced inappropriate intensive care admissions and safer transitions of care, findings supported by adult literature with potential cost-effectiveness. In Italy, limited intensive care capacity, regional disparities and lack of formal recognition of PIMCUs contributed to fragmented care pathways. The model developed by our Institute showed that an integrated PIMCU within a hub-and-spoke network improved patient flow, preserved intensive care capacity and enhanced system resilience. Conclusions: PIMCUs are key components of acuity-based paediatric care systems. Their implementation may improve efficiency, equity and patient safety. (© 2026 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.) |
| References: | Crit Care. 2025 Jan 20;29(1):34. (PMID: 39833886) JBI Evid Implement. 2025 Oct 24;:. (PMID: 41128160) Hosp Pediatr. 2020 Apr;10(4):347-352. (PMID: 32220935) Crit Care. 2025 Apr 23;29(1):157. (PMID: 40269982) Acta Paediatr. 2020 May;109(5):1062-1063. (PMID: 31730257) Hosp Pediatr. 2019 Jul;9(7):538-544. (PMID: 31253646) Crit Care Med. 2020 Jul;48(7):946-953. (PMID: 32317594) Indian J Pediatr. 2025 Feb;92(2):150-156. (PMID: 37971648) Crit Care Med. 2020 Jan;48(1):64-72. (PMID: 31609775) JAMA Intern Med. 2025 Jul 1;185(7):757-759. (PMID: 40423960) Hosp Pediatr. 2024 Jul 1;14(7):e317-e320. (PMID: 38867703) Crit Care Med. 2026 Feb 1;54(2):234-245. (PMID: 41217377) Front Pediatr. 2025 Apr 09;13:1539540. (PMID: 40270943) Pediatr Crit Care Med. 2025 Apr 1;26(4):e585-e587. (PMID: 39898765) Pediatr Pulmonol. 2023 Mar;58(3):918-926. (PMID: 36510441) Arch Dis Child. 2014 Jul;99(7):652-8. (PMID: 24686043) J Crit Care. 2017 Oct;41:268-274. (PMID: 28601043) Pediatrics. 2004 May;113(5):1430-3. (PMID: 15121967) Intensive Care Med. 2010 Aug;36(8):1403-9. (PMID: 20490781) Am J Emerg Med. 2023 Feb;64:169-173. (PMID: 36563501) Lancet. 2021 Dec 11;398(10317):2193-2206. (PMID: 34695372) Arch Dis Child. 2020 Feb;105(2):173-179. (PMID: 31401558) J Clin Med. 2025 Sep 10;14(18):. (PMID: 41010602) J Clin Med. 2025 Sep 17;14(18):. (PMID: 41010747) Crit Care. 2008;12(3):R68. (PMID: 18482443) Eur J Pediatr. 2026 Feb 16;185(3):134. (PMID: 41699321) Crit Care. 2014 Oct 09;18(5):551. (PMID: 25664865) Lancet. 2023 Oct 28;402(10412):1525. (PMID: 37898527) Pediatrics. 2022 May 1;149(5):. (PMID: 35490284) |
| Contributed Indexing: | Keywords: acuity‐aligned care; healthcare organization; high‐dependency unit; paediatric critical care networks; paediatric intermediate care unit |
| Entry Date(s): | Date Created: 20260528 Date Completed: 20260811 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13460445 |
| DOI: | 10.1111/apa.70608 |
| PMID: | 42207648 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1651-2227 |
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| DOI: | 10.1111/apa.70608 |