Intensivists in the pediatric intensive care unit: conductors for better operational efficiency

In this issue of Acute and Critical Care, Kwon et al. [1] from Kyungpook National University Children’s Hospital describe the impact of the presence of intensivists in the pediatric intensive care unit (PICU). Their study has several limitations, such as analyzing single-center data from a relatively short period, but they showed that pediatric intensivist staffing in the PICU might improve the operational efficiency of the unit. The authors suggested that the presence of intensivists in the PICU resulted in better occupancy and turnover rates of beds due to more efficient use of the limited resources in the unit. A previous study reported that the presence of intensivists in the PICU resulted in an improved survival rate [2], but Kwon et al. [1] did not show beneficial effects on overall mortality or length of stay in the PICU in their study. I speculate that this discrepancy may result from the fact that their unit is a medical and surgical complex unit, with many potential confounding variables.