Caring for acutely and critically ill pediatric patients is challenging and ever changing. The combination of children and adults in the same unit increases the complexity and can make it difficult for practitioners to maintain required competencies for practice. This article reviews the issues and strategies to consider when these 2 patient populations intersect.

The following are 3 scenarios in which adult patients are cared for in a pediatric intensive care unit (PICU): adult patients who have chronic pediatric conditions, such as cystic fibrosis or spina bifida; adult patients who require specialty care, such as extracorporeal membrane oxygenation therapy, which is provided only in the PICU; and adult patients who overflow to the PICU as a result of hospital resource constraints, generally limited bed availability. The relative contribution of each of these populations to the number of adult patients cared for in PICUs...

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