Delayed Referral of Children With Cancer to the Pediatric Intensive Care Unit: The Need for a Shared Care Pathway Between Oncology and Critical Care

Hesabi, Amir

doi:10.22034/hp.2026.604792.1099

Delayed Referral of Children With Cancer to the Pediatric Intensive Care Unit: The Need for a Shared Care Pathway Between Oncology and Critical Care

Document Type : Letter to the Editor

Author

Amir Hesabi

Pediatric Hematology and Oncology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

10.22034/hp.2026.604792.1099

Abstract

Advances in childhood cancer treatment have substantially improved survival; however, intensive therapies may cause severe infections, organ dysfunction, and rapid clinical deterioration. In these situations, pediatric intensive care units (PICUs) play a crucial role in providing life-sustaining support and enabling the continuation of cancer-directed treatment. Nevertheless, referral of children with cancer to the PICU may be delayed when clinicians perceive the underlying prognosis as poor or consider intensive interventions unlikely to be beneficial. Evidence indicates that many children with cancer survive PICU admission and may subsequently continue curative treatment. This letter highlights the need for a structured, shared care pathway involving pediatric oncology, critical care, infectious diseases, and palliative care teams to facilitate earlier recognition of deterioration and timely PICU referral.

Keywords

Childhood Cancer

Early Referral

Pediatric Intensive Care Unit

Palliative care

Sepsis