1146: Picu Infrastructure in India: A National Survey of Capacity, Capability, and Workforce

Introduction: High-quality pediatric intensive care requires adequate beds, monitoring, skilled teams, and advanced organ support. Limited national data from India hampers benchmarking and quality-improvement efforts. We hypothesized significant heterogeneity and resource gaps across the country. Methods: We conducted a nationwide, cross-sectional, questionnaire-based survey of PICU faculty between May–July 2025 Results: Data from 210 PICUs revealed 2,436 PICU and 986 HDU beds with steady growth. Most PICUs (75.7%) were private; 77.1% were Level III–IV, and 69.5% mixed units. Models included hybrid (51.0%), closed (43.3%), and open (5.7%). Isolation capacity was inconsistent; 38.1% had negative-pressure rooms. Only 20.0% used complete electronic records. Invasive ventilation was universal (1,597 ventilators); high-frequency and non-invasive ventilation were in 74.3% and 91.9%. Advanced organ support included peritoneal dialysis (90.5%), SLED/HD (76.2%), CRRT (55.7%), plasmapheresis (69.0%), inhaled nitric oxide (38.6%), and ECMO (30.0%); 34.3% had transplant programs. Neurocritical care capacity was limited: EEG/aEEG (82.9%), intracranial pressure monitoring (26.7%), near-infrared spectroscopy (11.0%), and targeted temperature management (25.2%). Hemodynamic adjuncts varied: point-of-care ultrasound (91.9%), invasive arterial pressure (88.1%), noninvasive cardiac output (37.1%), and advanced invasive monitoring (29.5%). The workforce included 527 faculty (36% without formal PICU training), 3,867 nurses, and 2,285 allied staff. Training gaps were notable: 41.9% ran physician programs (235 fellows/year), 68.1% lacked allied-health training, and simulation was regular in 29.5%. Beds were concentrated in Karnataka and Maharashtra, while CRRT/ECMO programs clustered in Southern/Western regions. Research capacity was modest: 76.2% had ethics committees, 11.0% joined multicenter studies, and 82.4% reported < 10 publications in 5 years. Conclusions: India’s PICU capacity is substantial but unevenly distributed. Key priorities include scaling closed-unit models and protected nurse ratios, regionalizing CRRT/ECMO services, strengthening digital infrastructure, and expanding accredited training to standardize care and enhance research readiness.