The burden of paediatric intensive care: an Australian and New Zealand perspective.

Most seriously ill children in Australia and New Zealand are cared for in specialised intensive care units associated with tertiary children's hospitals. Highly regionalised models of care are in operation. Children from remote areas are transported to intensive care by paediatric emergency transport services. Indigenous children have disease and injury patterns similar to parts of the developing world and are over-represented in the intensive care population. The outcome for children admitted to intensive care compares favourably with international benchmarks. There is also evidence of uniformity of outcomes across paediatric intensive care units in the region and that outcomes have been improving. Although there are some downward pressures on intensive care workloads (preventative strategies such as immunisation, safety campaigns), these are counterbalanced by new surgical initiatives and increasing expectations of extended high tech support for children with life shortening diseases and disabilities. This expanding group of technology-dependent children will be one of the major challenges facing health authorities and intensive care physicians in this region in the coming decade.