Epidemiology of Critical Illness in Children

This chapter defines the scope of pediatric critical illness. To understand the impact of ethical dilemmas among our patients, it is necessary to describe the patients being affected. Death among children has changed from a common reality, to a rare event. Within the United States, the mortality rate among children fell from 100 in 1000 births in 1900, down to 5.9 deaths among 1000 births in 2015. Within the PICU setting, mortality rates average among 2–3%. However, while deaths are few, these patients frequently have chronic medical conditions which make decision-making quite complicated. Children are increasing more technology dependent. When children do die, it is frequently requiring parental decisions upon withdrawal of that technology. The ethical issues that arise from PICU settings are increasingly around the chronically ill ICU patient that has arisen from advancements in modern medicine.