REVIEW article
Front. Pediatr.
Sec. Pediatric Critical Care
Volume 13 - 2025 | doi: 10.3389/fped.2025.1601875
Centralization and transport of critically ill pediatric patients
Provisionally accepted
- 1Gifu University Hospital, Gifu, Japan
- 2Saitama Children's Medical Center, Saitama, Saitama, Japan
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Background: Caring for critically ill pediatric patients requires specialized expertise, centralized facilities, and efficient transport systems. The centralization of pediatric intensive care units in tertiary centers has enhanced clinical outcomes, resource efficiency, and standardized care. In this study, we provided an updated review of the increase in need for specialized pediatric transport teams. Methods: We searched PubMed for peer-reviewed literature on the treatment and transport of critically ill pediatric patients, as well as websites of government agencies involved in reporting population prospects. The following search terms were used: pediatric intensive care units, specialized pediatric transport teams, centralization, and helicopter emergency medical services. Thereafter, an inductive qualitative content analysis was performed. Results: High-volume pediatric intensive care units are associated with lower risk-adjusted mortality rates and more efficient resource utilization. However, over-centralization may reduce quality. Effective patient transport depends on skilled personnel, coordination, and stabilization, regardless of the team's composition. Therefore, transport methods should be selected based on a patient's condition, distance, and regional resources. Although helicopters enable rapid transport, they pose risks such as patient-related adverse events, operational hazards, and high costs. Additionally, recent studies questioned the "golden hour" concept, emphasizing stabilization and timely care over speed. Telemedicine plays a crucial role in reducing unnecessary transfers, optimizing resources, and improving access to specialized care. Conclusions: As aging populations and declining birth rates reshape healthcare needs, the demand for specialized pediatric transport and telemedicine increases. Future strategies must address regional disparities, enhance cost-effectiveness, and integrate advanced technologies such as artificial intelligence to ensure equitable and high-quality pediatric care.
Keywords: Pediatric intensive care units, specialized pediatric transport teams, transport, Centralization, Helicopter emergency medical services, Telemedicine, patient stabilization, pediatric patients
Received: 28 Mar 2025; Accepted: 20 May 2025.
Copyright: © 2025 Kamidani and Okada. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ryo Kamidani, Gifu University Hospital, Gifu, Japan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.