The World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS) was established in Paris, in September 1997. It arose from the vision of several world leaders in the field of pediatric critical care who saw the opportunity to combine international expertise, experience and influence to improve the outcomes of children suffering from life threatening illness and injury.
It was recognized that, by connecting national societies into an international network, they could achieve more than any one nation working alone. They envisioned a global community that would further research and distribute knowledge needed to care for critically ill infants and children. Working together, the Federation can set priorities, provide resources to pursue new knowledge, and link working groups around the world to build on current research. It can also host forums for discussion on how these research findings can be adapted and implemented to provide options for practitioners in a range of settings around the world.
Since 1992, with the leadership of 4 dedicated presidents, WFPICCS has actively participated in as well as have successfully organized, supported, and sponsored many global congresses, workshops, training courses, and regional educational meetings on pediatric critical care.
WFPICCS Congress
Baltimore, USA
WFPICCS Congress
Rotterdam, The Netherlands
WFPICCS Congress
Montreal, Canada
President: Geoffrey A Barker
WFPICCS Congress
Boston, USA
President: Geoffrey A Barker
WFPICCS Congress
Geneva, Switzerland
President: Edwin van der Voort
WFPICCS Congress
Sydney, Australia
President: Andrew Argent
WFPICCS Congress
Istanbul, Turkey
President: Niranjan (Tex) Kissoon
WFPICCS Congress
Toronto, Canada
President: Sunit Singhi
WFPICCS Congress
Singapore
President: Paolo Biban
WFPICCS Congress
Virtual congress (instead of in-person in Mexico)
President: Stephen Jacobe
WFPICCS Congress
Virtual congress (instead of in-person in Cape Town)
President: Satoshi Nakagawa
WFPICCS Congress
Cancun, Mexico
President: Brenda Morrow
WFPICCS Congress: Baltimore, USA
WFPICCS Congress: Rotterdam, The Netherlands
WFPICCS Congress: Montreal, Canada
WFPICCS President: Geoffrey A Barker
WFPICCS Congress: Boston, USA
WFPICCS President: Edwin van der Voort
WFPICCS Congress: Geneva, Switzerland
WFPICCS President: Andrew Argent
WFPICCS Congress: Sydney, Australia
WFPICCS President: Niranjan (Tex) Kissoon
WFPICCS Congress: Istanbul, Turkey
WFPICCS President: Sunit Singhi
WFPICCS Congress: Toronto, Canada
WFPICCS President: Paolo Biban
WFPICCS Congress: Singapore
WFPICCS President: Stephen Jacobe
WFPICCS Congress: Virtual congress (instead of in-person in Mexico)
WFPICCS President: Satoshi Nakagawa
WFPICCS Congress: Virtual congress (instead of in-person in Cape Town)
WFPICCS President: Brenda Morrow
WFPICCS Congress: Cancun, Mexico
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Currently, WFPICCS has 52 national, international and regional member societies representing over 100,000 pediatric and neonatal critical care physicians, nurses and allied health care workers. Our official journal, the journal Pediatric Critical Care Medicine, covers a full range of scientific content with abstracts of selected articles published in Chinese, French, Italian, Japanese, Portuguese and Spanish translations – making news of advances in the field available to pediatric and neonatal intensive and critical care practitioners worldwide.
Browse our website to learn more about the projects WFPICCS is involved with that take care of critically sick children and their families by reaching out and collaborating internationally with pediatric and neonatal critical care professionals.
Pediatric Intensive Care in India started in early 90s, almost simultaneously at 4 centres in north, south and West by individual efforts. The pioneering Institutions were PGIMER, Chandigarh (Dr Sunit Singhi ), Sir Ganga Ram Hospital, Delhi (Dr K Chugh), Hinduja Hospital, Mumbai (Dr. Soonu Udani) and Child Trust Hospital, Chennai, (Dr Suchitra Ranjit). The pioneers were trained and worked abroad and returned to India to set up PICUs. Soon the specialty became popular with the pediatricians and in 1996 there were already 21 centres offering pediatric Intensive Care. Various mile stones in the growth of PIC are shown in table 1. The number grew steadily as shown in table 2 and table 3. In 2004 the number of Intensive Care units in the country had passed one hundred. During the early period many of worked with Limited Gadgets and equipment and tried to have indigenous manufactured equipment.
The tremendous growth in Pediatric Intensive Care had a lot to with continuous emphasis on training programs. Indian Academy Pediatrics (IAP) was quick in realising the importance of critical care training. IAP introduced Pediatric Advanced Life Support courses early nineties with help of our friends from the USA, especially Dr N Janakiraman. In 1995 a formal IAP-PALS courses were launched with me at the first national convener of the course. By the Year 2000 we had conducted almost 200 courses and had trained more than 7000 pediatricians.
A formal Pediatric Intensive Care group was formed within Indian Academy of Pediatrics in 1994 under the convener ship Dr K. Chugh. Subsequently it became IAP Intensive Care chapter under my chairmanship in the Year 1998. A Pediatrics section also started within Indian Society of Critical Care medicine with Dr Pravin Khilnani as the first chair. Formation of the professional bodies gave tremendous impetus to the growth of the speciality as shown in table 4. We had first National Conference of Pediatric Intensive Care in Nagpur under leadership Dr Satish Deopujari in the year 1999. It was followed next year at Chandigarh. Since then the conference is held every year with a galaxy of a speakers from India and abroad in the faculty discussing frontiers of the PIC. Even 26/11 terrorist attack of Mumbai did not dilute the resolve to hold the Conference in Mumbai on the same dates. An important and very popular part of the Conferences has been the Workshops helping with skill development, which are often attended by delegates from neighbouring Asian countries.
From National to International conference was not a long journey. In 2007, we organised an International Advanced Course in PIC and in 2009, First Asian Congress of Ped Intensive Care at Chandigarh. The later was attended by delegates from 21 countries and regional leaders from Asia, and the faculty included giants of Ped Intensive care such as Prof Geoff Barker, Dr Patrick Kochanek, Dr. Niranjan Kissoon, Dr Andrew Argent, Dr D Bohn and many others.
The teaching through short course by various Institutions created a demand for more organised formal training. In the Year 2000, 5 of us set together, me, Dr. Chugh, Dr Udani, Dr Ranjit, Dr Khilnani and decided to form a Pediatric Critical Care Council with the aim to develop a 1 years course under the aegis of Indian Academy of Pediatrics and Indian Society of Critical Care medicine, and accredit teachers and infrastructure for such a training. We sat for full two days, year after year to plan the end-of -training examination These endeavours of developing teaching program, end of the training evaluation and certification of training were tremendously supported by our friends from USA especially Drs. Ashok Sarnaik, Mohan Mysore, and Shekhar Venkatraman, and Dr Marraro from Italy. They and many other friends returned year after year on their own expenses to help us grow.
The first set of 4 trainees were from the four pioneering centres. The number of centres providing one year Fellowship training swell to 23 by 2009. With the growing knowledge and skills required in practice of PIC the fellowship was extended to two years. Simultaneously a two year fellowship in Pediatric Critical Care of National Board of Examinations was started in 2007 and a full-fledged 3 years training program, DM pediatric Critical Care, started in 2009 at PGIMER, Chandigarh. The current status of training facilities is given in table 5
Although the training and education were going strong but the research was lagging behind. PGIMER, Chandigarh and AIIMS Delhi were the only centre regular with research but soon the research picked up and Indian pediatric intensivists have contributed many original papers addressing the common issues notable among these papers on fluid therapy meningitis and pneumonia, fluid overload and multi-modal monitoring in Dengue, on diagnosis of VAP, perfusion pressure targeted therapy of CNS infections, role of probiotics in reducing candidemia in Pediatric Intensive Care units, management of septic shock specially fluid therapy, use of inhaled steroids in moderate exacerbation of asthma role of magnesium sulfate infusion in acute severe asthma. A multi-centre study on Tropical febrile illness under the ageis of ISCCM has helped in defining ICU treatment and consolidating guidelines for management of various tropical infections. Indian studies had been among winners of best paper awards at 2014 and 2016 WFPICCS Congress at Istanbul and Toronto respectively. Currently a multi-centre collaboration is in place addressing locally relevant issues. Pediatric Intensive Care Chapter Indian Academy of Pediatrics has also launched its own Journal, The Journal of Pediatric Intensive Care in 2013.
In nutshell, in last two decades India has made significant gains in the management of critically ill children. A well organized, multiple layered, training program has evolved- we are one of the few countries with a well organized training program in Pediatric Critical Care. We are now in a position to offer training in the field to physicians from other developing countries. Most of the PICUs in metropolitan cities have ‘state of Art’ facilities including ECMO. In large cities transport of critically ill child has moved on from a hand–ventilated child in a basic ambulance to a ‘state of art’ transport with that includes a trained team, transport ventilators, oximetry and ETCO2 etc.. Children previously thought to be too unstable for transport can now be safely transported from one center to a higher one.
We are continuously moving towards a more organised, state of art PIC facilities in Asia and had an Asian group meeting at Istanbul and now the WFPICCS Congress in concerning issue is facing the delivery of Intensive care in India is the disparity of care in various regions, Rural & Urban and the ‘Have & have nots’. This disparity is increasing with time in spite of the significant successes in the field of critical care in India. It is difficult to get appropriate facilities developed in tier two and three cities. We need to find ways of supporting the development of Pediatric critical care; facilitating the growth and development of research in pediatric critical care and supporting the work and development of all people who work in the setting of pediatric critical care.
From the end of 1980s to 1990s, many Chinese children’s hospitals and even pediatric departments of general hospitals have set up ICU. In the late 1980s, master degree candidates (major in pediatric critical care medicine) were enrolled; in 1990s, doctoral degree candidates were enrolled in Beijing, Shanghai, Chongqing, Shenyang and other cities in China; in addition, many young doctors and nurses were selected to go abroad for further training. These training programs have produced many senior pediatricians, who have become the mainstay of pediatric intensive care medicine in China.
With the development of pediatric intensive care medicine, academic organizations are expected to establish and promote academic exchanges. In 1988, the Sub-specialty Group of Pediatrics affiliated to Chinese Society of Emergency Medicine of Chinese Medical Association was established. Professor Zhao Xiangwen served as head of the group, and Professor Fan Xunmei as the deputy head. In 1993, the Group of Emergency Medicine affiliated to Chinese Pediatric Society of Chinese Medical Association was established and led by Professor Zhao Xiangwen and Professor Fan Xunmei.
Our academic society is the combination of two academic organizations (the Subspecialty Group of Pediatric and the Group of Emergency Medicine). Every two year, from 1989, our society has held the National Conference on Pediatric Critical Illness (NCPCI). Over the past 20 years, our academic society has organized 14 national conferences and many symposia on pediatric critical illness. We have made a positive contribution to the development of guideling and the promotion of the Chinese pediatric intensive care medicine.
In recent 10 years, with the rapid development of the national economy and the outbreak of public health emergencies such as hand-foot-and-mouth disease, Chinese pediatric critical care society has entered a period of rapid development. In China, the number of doctors and nurses engaging in pediatric intensive care medicine has been steadily increasing. The number of PICU in China has increased significantly, and the PICU capacity has gradually expanded. In order to standardize the diagnosis and treatment protocols of pediatric critical diseases and improve the treatment skills of care staff, our academic society has dedicated itself to providing clinical guidelines, in line with the development of PICU in local hospital throughout China. The list of details is as follows:
PICU plays an increasing important role in dealing with public health emergencies. The outbreak of SARS in 2003 increased the public aware of existence of PICU. During the widespread outbreaks in 2008 and 2009, groups of experts in pediatric intensive care medicine rushed to epidemic areas of hand-foot-and-mouth disease, under the guidance of the experts many critically ill children were cured. In addition, many PICUs were established in the prefecture-level cities and county-level cities of epidemic area, contributing greatly to the reduction of mortality in hand foot and foot disease. In the earthquake relief effort of Wenchuan (2008) and Yushu (2010), the PICU doctors also played an important role.
In July 4, 2008, intensive care medicine was formally incorporated into the medical discipline system in China and has become an independent second-level discipline paralleled by internal medicine and surgery. The National Health and Family Planning Commission of the People’s Republic of China (Ministry of Health) has explicitly required all the tertiary-level and some well-equipped secondary-level hospitals to have ICU, and the ICU service has been recognized as an important measurement in the hospital evaluation. According to the preliminary estimate, about 200 children’s hospitals and comprehensive hospitals in China have an independent PICU.
JSPICC hosted annual workshops to introduce state of the art information to the Japanese pediatric community, became a strong force in developing a close relationship with other Asian countries, and invited trainees from those countries to come to Japan to promote the teaching and development of pediatric critical care across Asia. JSPICC, as one of the few national organizations specialized in pediatric critical care in the 1990s, supported Dr. G.A. Barker to strengthen WFPICCS, including instituting the PCCM Journal. JSPICC recommended Dr. S. Iwai to be given posthumously a Gold Award for his contribution to pediatric critical care at the 3rd WFPICCS in Montreal, in 2000.
JSPICC strives to raise the recognition of pediatric critical care in Japan and one important development was the hosting of PALS training courses. The group proved to be an important resource to a Japanese governmental committee on pediatric brain death criteria with the help of Drs. G.A. Barker and A. Jarvis of HSC, Tex Kissoon of BC Children’s and Vinay Nadkarni of CHOP. JSPICC continued to foster the development of a new generation of pediatric intensivists and to play a major role in facilitating improved educational and structural guidelines.
Under the leadership of Dr. Hiro Sakai, a board member, and Ms. Akiko Ota, administrative assistant, extensive lobbying by JSPICC resulted in the establishment in 2002 of the National Center for Child Health and Development (NCCHD) in Tokyo from NCH. It became the national flagship children’s hospital, opening with a full PICU and ER. No children’s hospitals in Japan had PICUs, nor did they openly accept pediatric emergency cases until then.
JSPICC now has a membership of a little over 1000 and Japan now has 30 PICUs. Dr. Miyasaka was the president of JSPICC until 2012 when Dr. S. Nakagawa succeeded the position. JSPICC now has policies to promote exchange in Asia, transfer critical care technology to home care, and facilitate outcome research to substantiate the value of pediatric critical care.
