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Debate needed after sharp rise in children admitted to intensive care since 2009

Research published in the Archives of Diseases in Childhood shows a sharp rise in children admitted to intensive care in England and Wales since 2009, a trend which is not explained by either population growth or the rising birth rate.

An analysis of admissions data from the Paediatric Intensive Care Audit Network (PICANet) shows higher numbers of children with complex conditions being treated, which looks set to continue.

Authors of the study say this will prove challenging for services and commissioners as demand potentially outstrips resource.

This new analysis importantly highlights the growing pressure paediatric intensive care is under, putting the drop in funding growth into sharp context, and from which point demand has only increased.

What we know at the front line of paediatric intensive care is that expectations are shifting.

This is most obviously seen where decisions are being made about the balance between intensive interventions and palliation; we are increasingly treating children with complex disease more aggressively with a focus on prolonging their lives, with less certain expectations regarding their potential for improvement and quality of life.

We need an open, honest, debate in society about the course we are taking; it should ask if this is the right path, has it gone far enough, or perhaps has it gone too far?

Whatever the result of such a debate, appropriate resources must then follow to allow both the medical and social care to be delivered.

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