Background

Up to 40% of pediatric cancer patients require admission to PICU during the course of their disease. However, scarce are available on the standard of care in critical care delivery for this patient group, nor are systematic multi-center outcome data.

Objectives

To obtain consensus on the top five research priorities in the field of pediatric cancer patient critical care.

Methods

We conducted a three-round modified Delphi consensus process among pediatric intensivists and pediatric oncologists in Europe. An anonymous questionnaire was distributed online via SurveyMonkey. POKER consortium members drafted ten candidate research topics. Participants rated these topics using a 4-point scale. Research questions that met a priori consensus thresholds for >80% high priority were included in round 2, complemented with additional research topics suggested by participants. Round 2 yielded consensus on high prioritiy topics, which were ranked by POKER member in round 3 to create a final top five .

Results

One-hundred seventy-four and 154 colleagues participated in rounds 1 and 2, respectively (Fig. 1). Five research topics were identified as top priorities: (1) Optimal timing of the use of life-sustaining therapies; (2) Development of specific early warning scores; (3) Role of non-invasive ventilation in acute respiratory insufficiency; (4) End-of-life care and ethical issues; (5) Sepsis.

Profession and country of residence of the participants.

Conclusion

Admissions of pediatric cancer patients contribute to a substantial proportion of critical care patient- and work-load. In particular, optimum use of critical care resources in this group is an area requiring urgent research.