A Critical Care Journey

Satoshi Nakagawa

National Center for Child Health and Development

Tokyo, Japan

My Fellowship at SickKids

• From January 1993 to December 1994• Last night shift at the old ICU/building

• Then, spend a year and a half in Boston, USA• At Massachusetts General Hospital and New England Medical

Center

• Back to Japan in August 1996

Pediatric Critical Care in Japan

• 1981: first PICU at Osaka City Medical Center • 4 beds, for post-surgical care

• 1982: PICU at Kyoto Prefectural University of Medicine• 6 beds, for post-surgical care

• 1994: PICU at National Children’s Hospital (NCH), Tokyo • 12 beds, mainly for post-surgical care

• Managed by Drs. K Miyasaka, H Sakai and M Takata (ex-SickKids fellows)

Multidisciplinary PICUs in Japan

• NCH was transformed to National Center for Child Health and Development (NCCHD), 2002• First multidisciplinary PICU of 20 beds • Managed by S Nakagawa and N Shimizu, supported by K Miyasaka and H

Sakai

• Tokyo Metropolitan Children’s Medical Center, 2010 • PICU led by N Shimizu

• Aichi Children’s Health and Medical Center • PICU led by T Ikeyama

• Saitama Children’s Medical Center• PICU led by T Niitsu

Multidisciplinary PICUs in Japan

• NCH was transformed to National Center for Child Health and Development (NCCHD), 2002• First multidisciplinary PICU of 20 beds • Managed by S Nakagawa and N Shimizu, supported by K Miyasaka and H

Sakai

• Tokyo Metropolitan Children’s Medical Center, 2010 • PICU led by N Shimizu

• Aichi Children’s Health and Medical Center • PICU led by T Ikeyama

• Saitama Children’s Medical Center• PICU led by T Niitsu

PICUs in Japan

• Currently more than 30 PICUs

• Total beds exceeds 200 • only 2 % of ICU beds in the country

• Pediatric Intensive Care Workshop• Launched in 1994 and held annually since then

• PICU consortium is established by N Shimizu

PICUsin Asia

PICUs in resource limited areas

• Needs • Children are dying by infectious diseases and accidents

• Challenges • Limited manpower

• Limited equipment

• Infrastructure of medicine is not well established

• Collaboration between developed and developing nations • Human resource development

World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS)

• First World Congress of Pediatric Critical Care, Baltimore, USA, 1992

• 3rd World Congress, Montreal, Canada, 2000

• 5th World Congress, Geneva, Switzerland, 2007

• 8th World Congress, Toronto, Canada, 2016

• 9th World Congress, Singapore, 2018

• WFPICCS: established in 1997 • First President: Dr. Geoffrey Barker

(2000 to 2003)

• 4th President: Dr. Tex Kissoon(2011-2014)

• Satoshi becomes a board member of WFPICCS in 2011 • Currently Secretary and President-

Elect of WFPICCS

11th Congress in Cape Town, South Africa in 2022

Thank you for your attention