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| LETTER TO THE EDITOR |
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| Year : 2016 | Volume
: 9
| Issue : 3 | Page : 423 |
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Importance of separate neonatal surgical intensive care unit managed by the trained pediatric surgeons in every tertiary care center in India
Meely Panda1, Shasanka Shekhar Panda2, Aparajita Panda3, Pankaj Kumar Mohanty4, Sushree Samiksha Naik5
1 Department of Community Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
2 Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
3 Department of Anaesthesia, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
4 Department of Neonatology, Manipal Hospital, Bengaluru, Karnataka, India
5 Department of Obstetrics and Gynecology, SCB Medical College and Hospital, Cuttack, Odisha, India
| Date of Web Publication | 17-May-2016 |
Correspondence Address:
Shasanka Shekhar Panda
Department of Paediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0975-2870.182535
How to cite this article:
Panda M, Panda SS, Panda A, Mohanty PK, Naik SS. Importance of separate neonatal surgical intensive care unit managed by the trained pediatric surgeons in every tertiary care center in India. Med J DY Patil Univ 2016;9:423 |
Sir,
Survival of newborns not only depends on the quality of care provided but also on the spectrum of disease and demographic profile. If neonatal Intensive Care Unit (ICU) care is an emerging specialty in India, concept of neonatal surgical Intensive Care Unit (NSICU) managed by the trained pediatric surgeon is still newer in this part of the world.
In recent years, there has been a marked increase in the prenatal diagnosis of congenital malformations. A fetus with a suspected major congenital malformation should ideally be delivered in a hospital with pediatric surgical facilities. An integrated multidisciplinary approach to care is essential in the premature surgical neonate and in those with complex congenital malformations. Surgical neonates should be concentrated within specialist pediatric surgical units with adequate numbers of appropriately trained medical and nursing staff. Neonatal surgical units should be adequately staffed by pediatric surgeons with access to a full range of supporting services. An ideal pediatric surgical unit should be staffed by a minimum of four consultant pediatric surgeons and one pediatric urologist which provides adequate emergency cover and the development of subspecialties within centers. [1]
Over the years the number of admission to NSICU is on the rise. This is because of better referral setup and increasing awareness not only among the treating pediatricians but also among the general population regarding the pediatric surgical cases in our country. A gap exists between views of neonatal intensive care practices, with parents on one side and professionals and managers on the other. [2] Some of our policies such as maintenance of NSICU by pediatric surgeon are giving excellent results simply because of better understanding of the disease and its pathophysiology by the treating surgeons which is unfortunately lacking among the pediatricians. A treating pediatric surgeon is aware about the general condition of the neonate in a better way as compared to his pediatric counterpart and that is why we promote and encourage the management of neonatal surgical cases by the pediatric surgeons only.
There is very limited number of NSICU in our country. We are trying to emphasize upon the need and importance of a structured and dedicated NSICU. In an ICU managed by pediatricians, pediatric surgical cases unfortunately receive a low priority status partly because of the lack of interest in the field among the treating pediatrician and also because of lack of adequate knowledge about neonatal surgical cases on their part. We strongly feel that pediatric surgical cases should be managed by pediatric surgical residents and dedicated staff because this not only improves their survival but also decreases the morbidity associated due to improper care.
| References | |  |
| 1. | The British Association of Paediatric Surgeons. A Guide for Purchasers and Providers of Paediatric Surgical Services. London: The British Association of Paediatric Surgeons; 1995.  |
| 2. | Lantz B, Ottosson C. Neonatal intensive care practices: Perceptions of parents, professionals, and managers. Adv Neonatal Care 2014;14:E1-12. |
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