In the highly specialized field of caring for children in the PICU, Fuhrman and Zimmerman's Pediatric Critical Care is the definitive reference for all members of the pediatric intensive care team. Drs. Jerry J. Zimmerman and Alexandre T. Rotta, along with an expert team of editors and contributors from around the world, have carefully updated the 6th Edition of this highly regarded text to bring you the most authoritative and useful information on today’s pediatric critical care—everything from basic science to clinical applications.
1. Cover image - p. 1 2. Title page - p. 2 3. Table of Contents - p. 3 4. Copyright - p. 13 5. Contributors - p. 14 6. Preface - p. 25 7. Videos - p. 26 8. List of Tables - p. 27 9. List of Illustrations - p. 32 10. Section I: Pediatric Critical Care: The Discipline - p. 76 11. 1. History of pediatric critical care medicine - p. 77 12. 2. High-reliability pediatric intensive care unit: Role of intensivist and team in obtaining optimal outcomes - p. 99 13. 3. Critical communications in the pediatric intensive care unit - p. 108 14. 4. Professionalism in pediatric critical care - p. 115 15. 5. Leading and managing change in the pediatric intensive care unit - p. 118 16. 6. Evolution of critical care nursing - p. 126 17. 7. Fostering a learning healthcare environment in the pediatric intensive care unit - p. 138 18. 8. Challenges of pediatric critical care in resource-poor settings - p. 144 19. 9. Public health emergencies and emergency mass critical care - p. 156 20. 10. Lifelong learning in pediatric critical care - p. 164 21. Section II: Pediatric Critical Care: Tools and Procedures - p. 175 22. 11. Essential concepts in clinical trial design and statistical analysis - p. 176 23. 12. Prediction of short-term outcomes during critical illness in children - p. 187 24. 13. Pediatric critical care transport - p. 193 25. 14. Pediatric vascular access and centeses - p. 201 26. 15. Ultrasonography in the pediatric intensive care unit - p. 231 27. Section III: Pediatric Critical Care: Psychosocial and Societal - p. 250 28. 16. Patient- and family-centered care in the pediatric intensive care unit - p. 251 29. 17. Pediatric critical care ethics - p. 261 30. 18. Ethical issues around death and dying - p. 270 31. 19. Palliative care in the pediatric intensive care unit - p. 275 32. 20. Organ donation process and management of the organ donor - p. 283 33. 21. Long-term outcomes following critical illness in children - p. 307 34. 22. Burnout and resiliency - p. 323 35. Section IV: Pediatric Critical Care: Cardiovascular - p. 328 36. 23. Structure and function of the heart - p. 329 37. 24. Regional peripheral circulation - p. 352 38. 25. Endothelium and endotheliopathy - p. 363 39. 26. Principles of invasive cardiovascular monitoring - p. 373 40. 27. Assessment of cardiovascular function - p. 387 41. 28. Cardiac failure and ventricular assist devices - p. 401 42. 29. Echocardiographic imaging - p. 432 43. 30. Diagnostic and therapeutic cardiac catheterization - p. 452 44. 31. Pharmacology of the cardiovascular system - p. 466 45. 32. Cardiopulmonary interactions - p. 492 46. 33. Disorders of cardiac rhythm - p. 505 47. 34. Shock states - p. 525 48. 35. Pediatric cardiopulmonary bypass - p. 541 49. 36. Critical care after surgery for congenital cardiac disease - p. 562 50. Neonatal considerations - p. 563 51. Preoperative care - p. 563 52. Postoperative care - p. 565 53. Critical care management of selected specific lesions - p. 576 54. Summary - p. 591 55. Key references - p. 591 56. References - p. 592 57. 37. Cardiac transplantation - p. 601 58. 38. Physiologic foundations of cardiopulmonary resuscitation - p. 611 59. Mechanisms of blood flow - p. 612 60. Rate and duty cycle - p. 614 61. Newer cardiopulmonary resuscitation techniques - p. 616 62. Pharmacology - p. 620 63. Management of ventricular fibrillation - p. 628 64. Future directions - p. 633 65. Key references - p. 633 66. References - p. 635 67. 39. Performance of cardiopulmonary resuscitation in infants and children - p. 646 68. Section V: Pediatric Critical Care: Pulmonary - p. 660 69. 40. Structure and development of the upper respiratory system - p. 661 70. 41. Structure and development of the lower respiratory system - p. 666 71. 42. Physiology of the respiratory system - p. 673 72. 43. Noninvasive respiratory monitoring and assessment of gas exchange - p. 686 73. 44. Overview of breathing failure - p. 697 74. 45. Ventilation/perfusion inequality - p. 708 75. 46. Mechanical dysfunction of the respiratory system - p. 716 76. 47. Diseases of the upper respiratory tract - p. 729 77. 48. Pediatric acute respiratory distress syndrome and ventilator-associated lung injury - p. 743 78. 49. Acute viral bronchiolitis - p. 763 79. 50. Asthma - p. 776 80. 51. Neonatal pulmonary disease - p. 801 81. 52. Pneumonitis and interstitial disease - p. 824 82. Pathogenesis - p. 824 83. Pathophysiology - p. 825 84. Diagnosis - p. 825 85. Bacterial pneumonitis - p. 825 86. Viral pneumonitis - p. 830 87. Fungal pneumonitis - p. 835 88. Primary pulmonary fungi - p. 835 89. Opportunistic pulmonary mycoses - p. 838 90. Pneumocystis jirovecii pneumonia - p. 839 91. Chemical pneumonitis - p. 840 92. Idiopathic interstitial lung disease - p. 842 93. Pediatric pulmonary hemorrhage - p. 843 94. Summary - p. 846 95. Key references - p. 846 96. References - p. 849 97. 53. Diseases of the pulmonary circulation - p. 858 98. 54. Mechanical ventilation and respiratory care - p. 883 99. 55. Noninvasive ventilation in the pediatric intensive care unit - p. 902 100. 56. Extracorporeal life support - p. 920 101. 57. Pediatric lung transplantation - p. 948 102. Section VI: Pediatric Critical Care: Neurologic - p. 959 103. 58. Structure, function, and development of the nervous system - p. 960 104. 59. Critical care considerations for common neurosurgical conditions - p. 986 105. 60. Neurologic assessment and monitoring - p. 996 106. 61. Neuroimaging - p. 1017 107. 62. Coma and depressed sensorium - p. 1032 108. 63. Intracranial hypertension and monitoring - p. 1043 109. 64. Status epilepticus - p. 1052 110. 65. Hypoxic-ischemic encephalopathy - p. 1068 111. Epidemiology - p. 1069 112. Mechanisms of hypoxic-ischemic brain injury - p. 1069 113. Clinical pathophysiology - p. 1075 114. Clinical outcome and prognostication after pediatric cardiac arrest - p. 1078 115. Response of the immature brain to cardiac arrest - p. 1080 116. Treatment after cardiac arrest - p. 1081 117. Current and novel therapies and interventions - p. 1083 118. Futuristic approaches - p. 1086 119. Summary - p. 1088 120. Key references - p. 1088 121. References - p. 1090 122. 66. Pediatric stroke and intracerebral hemorrhage - p. 1104 123. 67. Central nervous system infections and related conditions - p. 1121 124. 68. Acute neuromuscular disease and disorders - p. 1148 125. 69. Acute rehabilitation and early mobility in the pediatric intensive care unit - p. 1163 126. Section VII: Pediatric Critical Care: Renal - p. 1176 127. 70. Renal structure and function - p. 1177 128. 71. Fluid and electrolyte issues in pediatric critical illness - p. 1187 129. 72. Acid-base disorders - p. 1218 130. 73. Tests of kidney function in children - p. 1248 131. 74. Glomerulotubular dysfunction and acute kidney injury - p. 1267 132. 75. Pediatric renal replacement therapy in the intensive care unit - p. 1296 133. 76. Pediatric renal transplantation - p. 1306 134. 77. Renal pharmacology - p. 1314 135. 78. Acute severe hypertension - p. 1324 136. Section VIII: Pediatric Critical Care: Metabolic and Endocrine - p. 1343 137. 79. Cellular respiration - p. 1344 138. 80. Biology of the stress response - p. 1360 139. 81. Inborn errors of metabolism - p. 1367 140. 82. Progress towards precision medicine in critical illness - p. 1384 141. 83. Molecular foundations of cellular injury - p. 1392 142. 84. Endocrine emergencies - p. 1402 143. 85. Diabetic ketoacidosis - p. 1418 144. Section IX: Pediatric Critical Care: Hematology and Oncology - p. 1430 145. 86. Structure and function of the hematopoietic organs - p. 1431 146. 87. The erythron - p. 1441 147. 88. Hemoglobinopathies - p. 1456 148. 89. Coagulation and coagulopathy - p. 1469 149. 90. Thrombosis in pediatric critical care - p. 1497 150. 91. Transfusion medicine - p. 1511 151. 92. Hematology and oncology problems - p. 1535 152. 93. Critical illness in children undergoing hematopoietic progenitor cell transplantation - p. 1549 153. Section X: Pediatric Critical Care: Gastroenterology and Nutrition - p. 1581 154. 94. Gastrointestinal structure and function - p. 1582 155. 95. Disorders and diseases of the gastrointestinal system - p. 1593 156. 96. Acute liver failure - p. 1612 157. 97. Hepatic transplantation - p. 1621 158. 98. Acute abdomen - p. 1628 159. 99. Nutrition of the critically ill child - p. 1636 160. Section XI: Pediatric Critical Care: Immunity and Infection - p. 1655 161. 100. Innate immunity - p. 1656 162. 101. Adaptive immunity - p. 1667 163. 102. Critical illness and the microbiome - p. 1675 164. 103. Congenital immunodeficiency - p. 1686 165. 104. Acquired immune dysfunction - p. 1709 166. 105. Immune balance in critical illness - p. 1733 167. 106. Pediatric rheumatologic disease - p. 1743 168. 107. Bacterial and fungal infections - p. 1765 169. 108. Life-threatening viral diseases and their treatment - p. 1781 170. 109. Healthcare-associated infections - p. 1799 171. 110. Pediatric sepsis - p. 1812 172. 111. Multiple-organ dysfunction syndrome - p. 1842 173. Section XII: Pediatric Critical Care: Environmental Injury and Trauma - p. 1853 174. 112. Bites and stings - p. 1854 175. 113. Hyperthermic injury - p. 1864 176. 114. Accidental hypothermia - p. 1872 177. 115. Drowning - p. 1880 178. 116. Burn and inhalation injury - p. 1894 179. 117. Evaluation, stabilization, and initial management after trauma - p. 1917 180. 118. Traumatic brain injury - p. 1929 181. 119. Pediatric thoracic trauma - p. 1961 182. 120. Pediatric abdominal trauma - p. 1971 183. 121. Child abuse - p. 1980 184. Section XIII: Pediatric Critical Care: Pharmacology and Toxicology - p. 1989 185. 122. Principles of drug disposition - p. 1990 186. 123. Molecular mechanisms of drug actions - p. 2008 187. 124. Adverse drug reactions and drug-drug interactions - p. 2023 188. 125. Principles of toxin assessment and screening - p. 2052 189. 126. Toxidromes and their treatment - p. 2063 190. Section XIV: Pediatric Critical Care: Anesthesia Principles in the Pediatric Intensive Care Unit - p. 2080 191. 127. Airway management - p. 2081 192. 128. Anesthesia effects on organ systems - p. 2113 193. 129. Anesthesia principles and operating room anesthesia regimens - p. 2124 194. 130. Malignant hyperthermia - p. 2143 195. 131. Neuromuscular blocking agents - p. 2153 196. 132. Sedation and analgesia - p. 2174 197. Posttraumatic stress disorder - p. 2175 198. Sedation scoring and assessment - p. 2175 199. Opioids and analgesia in the pediatric intensive care unit - p. 2177 200. Specific opioid agonists - p. 2178 201. Opiate antagonists - p. 2178 202. Incidental pain syndromes in the pediatric intensive care unit - p. 2178 203. Opiate tolerance - p. 2179 204. Benzodiazepines - p. 2182 205. Specific benzodiazepines - p. 2183 206. Flumazenil - p. 2184 207. Other agents for sedation in the pediatric intensive care unit - p. 2185 208. Neuroleptic malignant syndrome - p. 2187 209. Baclofen - p. 2187 210. Cannabis - p. 2188 211. Dexmedetomidine - p. 2189 212. Propofol - p. 2190 213. Ketamine - p. 2194 214. Etomidate - p. 2195 215. Inhalational anesthetic agents - p. 2196 216. Inhalation agent withdrawal syndrome - p. 2198 217. Sedation for children with preexisting cognitive impairment - p. 2198 218. Apoptosis and neurocognitive effects of anesthetic agents - p. 2198 219. Sedation-related complications - p. 2199 220. Pharmacoeconomics of analgesia and sedation in the pediatric intensive care unit - p. 2200 221. Key references - p. 2201 222. References - p. 2202 223. 133. Tolerance, dependency, and withdrawal - p. 2211 224. 134. Pediatric delirium - p. 2219 225. 135. Procedural sedation for the pediatric intensivist - p. 2228 226. Section XV: Pediatric Critical Care: Board Review Questions - p. 2234 227. 136. Board review questions - p. 2235 228. Chapter 1: History of pediatric critical care medicine - p. 2235 229. Chapter 2: High-reliability pediatric intensive care unit: role of intensivist and team in obtaining optimal outcomes - p. 2235 230. Chapter 3: Critical communication in the pediatric intensive care unit - p. 2236 231. Chapter 4: Professionalism in pediatric critical care - p. 2236 232. Chapter 5: Leading and managing change in the pediatric intensive care unit - p. 2236 233. Chapter 7: Fostering a learning healthcare environment in the pediatric intensive care unit - p. 2238 234. Chapter 8: Challenges of pediatric critical care in resource-poor settings - p. 2239 235. Chapter 9: Public health emergencies and emergency mass critical care - p. 2240 236. Chapter 10: Lifelong learning in pediatric critical care - p. 2240 237. Chapter 11: Essential concepts in clinical trial design and statistical analysis - p. 2241 238. Chapter 12: Prediction tools for short-term outcomes following critical illness in children - p. 2242 239. Chapter 13: Pediatric critical care transport - p. 2244 240. Chapter 14: Pediatric vascular access and centeses - p. 2245 241. Chapter 15: Ultrasonography in the pediatric intensive care unit - p. 2246 242. Chapter 16: Patient- and family-centered care in the pediatric intensive care unit - p. 2247 243. Chapter 17: Pediatric critical care ethics - p. 2248 244. Chapter 18: Ethical issues around death and dying - p. 2250 245. Chapter 19: Palliative care in the pediatric intensive care unit - p. 2250 246. Chapter 20: Organ donation process and management of the organ donor - p. 2252 247. Chapter 21: Long-term outcomes following critical illness in children - p. 2255 248. Chapter 22: Burnout and resiliency - p. 2256 249. Chapter 23: Structure and function of the heart - p. 2257 250. Chapter 24: Regional and peripheral circulation - p. 2260 251. Chapter 25: Endothelium and endotheliopathy - p. 2263 252. Chapter 26: Principles of invasive cardiovascular monitoring - p. 2265 253. Chapter 27: Assessment of cardiovascular function - p. 2267 254. Chapter 28: Cardiac failure and ventricular assist devices - p. 2271 255. Chapter 29: Echocardiographic imaging - p. 2272 256. Chapter 30: Diagnostic and therapeutic cardiac catheterization - p. 2274 257. Chapter 31: Pharmacology of the cardiovascular system - p. 2277 258. Chapter 32: Cardiopulmonary interaction - p. 2282 259. Chapter 33: Disorders of cardiac rhythm - p. 2284 260. Chapter 34: Shock states - p. 2284 261. Chapter 35: Pediatric cardiopulmonary bypass - p. 2286 262. Chapter 36: Critical care after surgery for congenital cardiac disease - p. 2287 263. Chapter 37: Cardiac transplantation - p. 2289 264. Chapter 38: Physiologic foundations of cardiopulmonary resuscitation - p. 2292 265. Chapter 39: Performance of cardiopulmonary resuscitation in infants and children - p. 2293 266. Chapter 40: Structure and development of the upper respiratory system - p. 2295 267. Chapter 41: Structure and development of the lower respiratory system - p. 2296 268. Chapter 42: Physiology of the respiratory system - p. 2297 269. Chapter 43: Noninvasive respiratory monitoring and assessment of gas exchange - p. 2297 270. Chapter 44: Overview of breathing failure - p. 2299 271. Chapter 45: Ventilation/perfusion inequality - p. 2301 272. Chapter 46: Mechanical dysfunction of the respiratory system - p. 2304 273. Chapter 47: Diseases of the upper respiratory tract - p. 2308 274. Chapter 48: Pediatric acute respiratory distress syndrome and ventilator-associated lung injury - p. 2309 275. Chapter 49: Acute viral bronchiolitis - p. 2311 276. Chapter 50: Asthma - p. 2312 277. Chapter 51: Neonatal pulmonary disease - p. 2314 278. Chapter 52: Pneumonitis and interstitial disease - p. 2315 279. Chapter 53: Diseases of the pulmonary circulation - p. 2317 280. Chapter 54: Mechanical ventilation and respiratory care - p. 2319 281. Chapter 55: Noninvasive ventilation in the pediatric intensive care unit - p. 2321 282. Chapter 56: Extracorporeal life support - p. 2323 283. Chapter 57: Pediatric lung transplantation - p. 2325 284. Chapter 58: Structure, function, and development of the nervous system - p. 2326 285. Chapter 59: Critical care considerations for common neurosurgical conditions - p. 2327 286. Chapter 60: Neurologic assessment and monitoring - p. 2328 287. Chapter 61: Neuroimaging - p. 2330 288. Chapter 62: Coma and depressed sensorium - p. 2331 289. Chapter 63: Intracranial hypertension and monitoring - p. 2335 290. Chapter 64: Status epilepticus - p. 2335 291. Chapter 65: Anoxic ischemic encephalopathy - p. 2338 292. Chapter 66: Pediatric stroke and intracerebral hemorrhage - p. 2343 293. Chapter 67: Central nervous system infections and related conditions - p. 2343 294. Chapter 68: Acute neuromuscular disease and disorders - p. 2346 295. Chapter 70: Renal structure and function - p. 2350 296. Chapter 71: Fluid and electrolyte issues in pediatric critical illness - p. 2352 297. Chapter 72: Acid-base balance in critical illness - p. 2353 298. Chapter 73: Tests of kidney function in children - p. 2355 299. Chapter 74: Glomerulotubular dysfunction and acute kidney injury - p. 2357 300. Chapter 75: Pediatric renal replacement therapy in the intensive care unit - p. 2359 301. Chapter 76: Pediatric renal transplantation - p. 2359 302. Chapter 77: Renal pharmacology - p. 2359 303. Chapter 78: Hypertensive urgencies and emergencies - p. 2360 304. Chapter 79: Cellular respiration - p. 2362 305. Chapter 80: Biology of the stress response - p. 2364 306. Chapter 81: Inborn errors of metabolism - p. 2365 307. Chapter 82: Genetic variation in health and disease - p. 2365 308. Chapter 83: Molecular foundations of cellular injury - p. 2367 309. Chapter 84: Endocrine emergencies - p. 2368 310. Chapter 85: Diabetic ketoacidosis - p. 2369 311. Chapter 86: Structure and function of the hematopoietic organs - p. 2371 312. Chapter 87: The erythron - p. 2373 313. Chapter 88: Hemoglobinopathies - p. 2374 314. Chapter 89: Coagulation and coagulopathy - p. 2377 315. Chapter 90: Thrombosis in pediatric critical care - p. 2379 316. Chapter 91: Transfusion medicine - p. 2379 317. Chapter 92: Hematology and oncology problems - p. 2380 318. Chapter 93: Critical illness in children undergoing hematopoietic progenitor cell transplantation - p. 2383 319. Chapter 94: Gastrointestinal structure and function - p. 2386 320. Chapter 95: Disorders of the gastrointestinal system - p. 2387 321. Chapter 96: Acute liver failure - p. 2390 322. Chapter 97: Hepatic transplantation - p. 2392 323. Chapter 98: Acute abdomen - p. 2393 324. Chapter 99: Nutrition of the critically ill child - p. 2394 325. Chapter 100: Innate immunity - p. 2395 326. Chapter 101: Adaptive immunity - p. 2400 327. Chapter 102: Critical illness and the microbiome - p. 2400 328. Chapter 103: Congenital immunodeficiencies - p. 2400 329. Chapter 104: Acquired immune dysfunction - p. 2402 330. Chapter 105: Immune balance in critical illness - p. 2404 331. Chapter 106: Pediatric rheumatologic disease - p. 2405 332. Chapter 107: Bacterial and fungal infections - p. 2407 333. Chapter 108: Life-threatening viral diseases and their treatment - p. 2408 334. Chapter 109: Healthcare-associated infections - p. 2410 335. Chapter 110: Pediatric sepsis - p. 2411 336. Chapter 111: Multiple organ dysfunction syndrome - p. 2413 337. Chapter 112: Bites and stings - p. 2414 338. Chapter 113: Hyperthermic injury - p. 2414 339. Chapter 114: Hypothermic injury - p. 2417 340. Chapter 115: Drowning - p. 2418 341. Chapter 116: Burn and inhalation injuries in children - p. 2421 342. Chapter 117: Evaluation, stabilization, and initial management after trauma - p. 2424 343. Chapter 118: Traumatic brain injury - p. 2424 344. Chapter 119: Pediatric thoracic trauma - p. 2427 345. Chapter 120: Pediatric abdominal trauma - p. 2428 346. Chapter 121: Child abuse - p. 2430 347. Chapter 122: Principles of drug disposition - p. 2430 348. Chapter 123: Molecular mechanisms of drug action - p. 2431 349. Chapter 124: Adverse drug reactions and drug-drug interactions - p. 2433 350. Chapter 125: Principles of toxin assessment and screening - p. 2434 351. Chapter 126: Toxidromes and their treatment - p. 2436 352. Chapter 127: Airway management - p. 2438 353. Chapter 128: Anesthesia effects on organ systems - p. 2439 354. Chapter 129: Anesthesia principles and operating room anesthesia regimens - p. 2440 355. Chapter 130: Malignant hyperthermia - p. 2442 356. Chapter 131: Neuromuscular blocking agents - p. 2443 357. Chapter 132: Sedation and analgesia - p. 2445 358. Chapter 133: Tolerance, dependency, and withdrawal - p. 2449 359. Chapter 134: Pediatric delirium - p. 2450 360. Chapter 135: Procedural sedation for the pediatric intensivist - p. 2450 361. Index - p. 2451
In the highly specialized field of caring for children in the PICU, Fuhrman and Zimmerman's Pediatric Critical Care is the definitive reference for all members of the pediatric intensive care team. Drs. Jerry J. Zimmerman and Alexandre T. Rotta, along with an expert team of editors and contributors from around the world, have carefully updated the 6th Edition of this highly regarded text to bring you the most authoritative and useful information on today’s pediatric critical care—everything from basic science to clinical applications.
1. Cover image - p. 1 2. Title page - p. 2 3. Table of Contents - p. 3 4. Copyright - p. 13 5. Contributors - p. 14 6. Preface - p. 25 7. Videos - p. 26 8. List of Tables - p. 27 9. List of Illustrations - p. 32 10. Section I: Pediatric Critical Care: The Discipline - p. 76 11. 1. History of pediatric critical care medicine - p. 77 12. 2. High-reliability pediatric intensive care unit: Role of intensivist and team in obtaining optimal outcomes - p. 99 13. 3. Critical communications in the pediatric intensive care unit - p. 108 14. 4. Professionalism in pediatric critical care - p. 115 15. 5. Leading and managing change in the pediatric intensive care unit - p. 118 16. 6. Evolution of critical care nursing - p. 126 17. 7. Fostering a learning healthcare environment in the pediatric intensive care unit - p. 138 18. 8. Challenges of pediatric critical care in resource-poor settings - p. 144 19. 9. Public health emergencies and emergency mass critical care - p. 156 20. 10. Lifelong learning in pediatric critical care - p. 164 21. Section II: Pediatric Critical Care: Tools and Procedures - p. 175 22. 11. Essential concepts in clinical trial design and statistical analysis - p. 176 23. 12. Prediction of short-term outcomes during critical illness in children - p. 187 24. 13. Pediatric critical care transport - p. 193 25. 14. Pediatric vascular access and centeses - p. 201 26. 15. Ultrasonography in the pediatric intensive care unit - p. 231 27. Section III: Pediatric Critical Care: Psychosocial and Societal - p. 250 28. 16. Patient- and family-centered care in the pediatric intensive care unit - p. 251 29. 17. Pediatric critical care ethics - p. 261 30. 18. Ethical issues around death and dying - p. 270 31. 19. Palliative care in the pediatric intensive care unit - p. 275 32. 20. Organ donation process and management of the organ donor - p. 283 33. 21. Long-term outcomes following critical illness in children - p. 307 34. 22. Burnout and resiliency - p. 323 35. Section IV: Pediatric Critical Care: Cardiovascular - p. 328 36. 23. Structure and function of the heart - p. 329 37. 24. Regional peripheral circulation - p. 352 38. 25. Endothelium and endotheliopathy - p. 363 39. 26. Principles of invasive cardiovascular monitoring - p. 373 40. 27. Assessment of cardiovascular function - p. 387 41. 28. Cardiac failure and ventricular assist devices - p. 401 42. 29. Echocardiographic imaging - p. 432 43. 30. Diagnostic and therapeutic cardiac catheterization - p. 452 44. 31. Pharmacology of the cardiovascular system - p. 466 45. 32. Cardiopulmonary interactions - p. 492 46. 33. Disorders of cardiac rhythm - p. 505 47. 34. Shock states - p. 525 48. 35. Pediatric cardiopulmonary bypass - p. 541 49. 36. Critical care after surgery for congenital cardiac disease - p. 562 50. Neonatal considerations - p. 563 51. Preoperative care - p. 563 52. Postoperative care - p. 565 53. Critical care management of selected specific lesions - p. 576 54. Summary - p. 591 55. Key references - p. 591 56. References - p. 592 57. 37. Cardiac transplantation - p. 601 58. 38. Physiologic foundations of cardiopulmonary resuscitation - p. 611 59. Mechanisms of blood flow - p. 612 60. Rate and duty cycle - p. 614 61. Newer cardiopulmonary resuscitation techniques - p. 616 62. Pharmacology - p. 620 63. Management of ventricular fibrillation - p. 628 64. Future directions - p. 633 65. Key references - p. 633 66. References - p. 635 67. 39. Performance of cardiopulmonary resuscitation in infants and children - p. 646 68. Section V: Pediatric Critical Care: Pulmonary - p. 660 69. 40. Structure and development of the upper respiratory system - p. 661 70. 41. Structure and development of the lower respiratory system - p. 666 71. 42. Physiology of the respiratory system - p. 673 72. 43. Noninvasive respiratory monitoring and assessment of gas exchange - p. 686 73. 44. Overview of breathing failure - p. 697 74. 45. Ventilation/perfusion inequality - p. 708 75. 46. Mechanical dysfunction of the respiratory system - p. 716 76. 47. Diseases of the upper respiratory tract - p. 729 77. 48. Pediatric acute respiratory distress syndrome and ventilator-associated lung injury - p. 743 78. 49. Acute viral bronchiolitis - p. 763 79. 50. Asthma - p. 776 80. 51. Neonatal pulmonary disease - p. 801 81. 52. Pneumonitis and interstitial disease - p. 824 82. Pathogenesis - p. 824 83. Pathophysiology - p. 825 84. Diagnosis - p. 825 85. Bacterial pneumonitis - p. 825 86. Viral pneumonitis - p. 830 87. Fungal pneumonitis - p. 835 88. Primary pulmonary fungi - p. 835 89. Opportunistic pulmonary mycoses - p. 838 90. Pneumocystis jirovecii pneumonia - p. 839 91. Chemical pneumonitis - p. 840 92. Idiopathic interstitial lung disease - p. 842 93. Pediatric pulmonary hemorrhage - p. 843 94. Summary - p. 846 95. Key references - p. 846 96. References - p. 849 97. 53. Diseases of the pulmonary circulation - p. 858 98. 54. Mechanical ventilation and respiratory care - p. 883 99. 55. Noninvasive ventilation in the pediatric intensive care unit - p. 902 100. 56. Extracorporeal life support - p. 920 101. 57. Pediatric lung transplantation - p. 948 102. Section VI: Pediatric Critical Care: Neurologic - p. 959 103. 58. Structure, function, and development of the nervous system - p. 960 104. 59. Critical care considerations for common neurosurgical conditions - p. 986 105. 60. Neurologic assessment and monitoring - p. 996 106. 61. Neuroimaging - p. 1017 107. 62. Coma and depressed sensorium - p. 1032 108. 63. Intracranial hypertension and monitoring - p. 1043 109. 64. Status epilepticus - p. 1052 110. 65. Hypoxic-ischemic encephalopathy - p. 1068 111. Epidemiology - p. 1069 112. Mechanisms of hypoxic-ischemic brain injury - p. 1069 113. Clinical pathophysiology - p. 1075 114. Clinical outcome and prognostication after pediatric cardiac arrest - p. 1078 115. Response of the immature brain to cardiac arrest - p. 1080 116. Treatment after cardiac arrest - p. 1081 117. Current and novel therapies and interventions - p. 1083 118. Futuristic approaches - p. 1086 119. Summary - p. 1088 120. Key references - p. 1088 121. References - p. 1090 122. 66. Pediatric stroke and intracerebral hemorrhage - p. 1104 123. 67. Central nervous system infections and related conditions - p. 1121 124. 68. Acute neuromuscular disease and disorders - p. 1148 125. 69. Acute rehabilitation and early mobility in the pediatric intensive care unit - p. 1163 126. Section VII: Pediatric Critical Care: Renal - p. 1176 127. 70. Renal structure and function - p. 1177 128. 71. Fluid and electrolyte issues in pediatric critical illness - p. 1187 129. 72. Acid-base disorders - p. 1218 130. 73. Tests of kidney function in children - p. 1248 131. 74. Glomerulotubular dysfunction and acute kidney injury - p. 1267 132. 75. Pediatric renal replacement therapy in the intensive care unit - p. 1296 133. 76. Pediatric renal transplantation - p. 1306 134. 77. Renal pharmacology - p. 1314 135. 78. Acute severe hypertension - p. 1324 136. Section VIII: Pediatric Critical Care: Metabolic and Endocrine - p. 1343 137. 79. Cellular respiration - p. 1344 138. 80. Biology of the stress response - p. 1360 139. 81. Inborn errors of metabolism - p. 1367 140. 82. Progress towards precision medicine in critical illness - p. 1384 141. 83. Molecular foundations of cellular injury - p. 1392 142. 84. Endocrine emergencies - p. 1402 143. 85. Diabetic ketoacidosis - p. 1418 144. Section IX: Pediatric Critical Care: Hematology and Oncology - p. 1430 145. 86. Structure and function of the hematopoietic organs - p. 1431 146. 87. The erythron - p. 1441 147. 88. Hemoglobinopathies - p. 1456 148. 89. Coagulation and coagulopathy - p. 1469 149. 90. Thrombosis in pediatric critical care - p. 1497 150. 91. Transfusion medicine - p. 1511 151. 92. Hematology and oncology problems - p. 1535 152. 93. Critical illness in children undergoing hematopoietic progenitor cell transplantation - p. 1549 153. Section X: Pediatric Critical Care: Gastroenterology and Nutrition - p. 1581 154. 94. Gastrointestinal structure and function - p. 1582 155. 95. Disorders and diseases of the gastrointestinal system - p. 1593 156. 96. Acute liver failure - p. 1612 157. 97. Hepatic transplantation - p. 1621 158. 98. Acute abdomen - p. 1628 159. 99. Nutrition of the critically ill child - p. 1636 160. Section XI: Pediatric Critical Care: Immunity and Infection - p. 1655 161. 100. Innate immunity - p. 1656 162. 101. Adaptive immunity - p. 1667 163. 102. Critical illness and the microbiome - p. 1675 164. 103. Congenital immunodeficiency - p. 1686 165. 104. Acquired immune dysfunction - p. 1709 166. 105. Immune balance in critical illness - p. 1733 167. 106. Pediatric rheumatologic disease - p. 1743 168. 107. Bacterial and fungal infections - p. 1765 169. 108. Life-threatening viral diseases and their treatment - p. 1781 170. 109. Healthcare-associated infections - p. 1799 171. 110. Pediatric sepsis - p. 1812 172. 111. Multiple-organ dysfunction syndrome - p. 1842 173. Section XII: Pediatric Critical Care: Environmental Injury and Trauma - p. 1853 174. 112. Bites and stings - p. 1854 175. 113. Hyperthermic injury - p. 1864 176. 114. Accidental hypothermia - p. 1872 177. 115. Drowning - p. 1880 178. 116. Burn and inhalation injury - p. 1894 179. 117. Evaluation, stabilization, and initial management after trauma - p. 1917 180. 118. Traumatic brain injury - p. 1929 181. 119. Pediatric thoracic trauma - p. 1961 182. 120. Pediatric abdominal trauma - p. 1971 183. 121. Child abuse - p. 1980 184. Section XIII: Pediatric Critical Care: Pharmacology and Toxicology - p. 1989 185. 122. Principles of drug disposition - p. 1990 186. 123. Molecular mechanisms of drug actions - p. 2008 187. 124. Adverse drug reactions and drug-drug interactions - p. 2023 188. 125. Principles of toxin assessment and screening - p. 2052 189. 126. Toxidromes and their treatment - p. 2063 190. Section XIV: Pediatric Critical Care: Anesthesia Principles in the Pediatric Intensive Care Unit - p. 2080 191. 127. Airway management - p. 2081 192. 128. Anesthesia effects on organ systems - p. 2113 193. 129. Anesthesia principles and operating room anesthesia regimens - p. 2124 194. 130. Malignant hyperthermia - p. 2143 195. 131. Neuromuscular blocking agents - p. 2153 196. 132. Sedation and analgesia - p. 2174 197. Posttraumatic stress disorder - p. 2175 198. Sedation scoring and assessment - p. 2175 199. Opioids and analgesia in the pediatric intensive care unit - p. 2177 200. Specific opioid agonists - p. 2178 201. Opiate antagonists - p. 2178 202. Incidental pain syndromes in the pediatric intensive care unit - p. 2178 203. Opiate tolerance - p. 2179 204. Benzodiazepines - p. 2182 205. Specific benzodiazepines - p. 2183 206. Flumazenil - p. 2184 207. Other agents for sedation in the pediatric intensive care unit - p. 2185 208. Neuroleptic malignant syndrome - p. 2187 209. Baclofen - p. 2187 210. Cannabis - p. 2188 211. Dexmedetomidine - p. 2189 212. Propofol - p. 2190 213. Ketamine - p. 2194 214. Etomidate - p. 2195 215. Inhalational anesthetic agents - p. 2196 216. Inhalation agent withdrawal syndrome - p. 2198 217. Sedation for children with preexisting cognitive impairment - p. 2198 218. Apoptosis and neurocognitive effects of anesthetic agents - p. 2198 219. Sedation-related complications - p. 2199 220. Pharmacoeconomics of analgesia and sedation in the pediatric intensive care unit - p. 2200 221. Key references - p. 2201 222. References - p. 2202 223. 133. Tolerance, dependency, and withdrawal - p. 2211 224. 134. Pediatric delirium - p. 2219 225. 135. Procedural sedation for the pediatric intensivist - p. 2228 226. Section XV: Pediatric Critical Care: Board Review Questions - p. 2234 227. 136. Board review questions - p. 2235 228. Chapter 1: History of pediatric critical care medicine - p. 2235 229. Chapter 2: High-reliability pediatric intensive care unit: role of intensivist and team in obtaining optimal outcomes - p. 2235 230. Chapter 3: Critical communication in the pediatric intensive care unit - p. 2236 231. Chapter 4: Professionalism in pediatric critical care - p. 2236 232. Chapter 5: Leading and managing change in the pediatric intensive care unit - p. 2236 233. Chapter 7: Fostering a learning healthcare environment in the pediatric intensive care unit - p. 2238 234. Chapter 8: Challenges of pediatric critical care in resource-poor settings - p. 2239 235. Chapter 9: Public health emergencies and emergency mass critical care - p. 2240 236. Chapter 10: Lifelong learning in pediatric critical care - p. 2240 237. Chapter 11: Essential concepts in clinical trial design and statistical analysis - p. 2241 238. Chapter 12: Prediction tools for short-term outcomes following critical illness in children - p. 2242 239. Chapter 13: Pediatric critical care transport - p. 2244 240. Chapter 14: Pediatric vascular access and centeses - p. 2245 241. Chapter 15: Ultrasonography in the pediatric intensive care unit - p. 2246 242. Chapter 16: Patient- and family-centered care in the pediatric intensive care unit - p. 2247 243. Chapter 17: Pediatric critical care ethics - p. 2248 244. Chapter 18: Ethical issues around death and dying - p. 2250 245. Chapter 19: Palliative care in the pediatric intensive care unit - p. 2250 246. Chapter 20: Organ donation process and management of the organ donor - p. 2252 247. Chapter 21: Long-term outcomes following critical illness in children - p. 2255 248. Chapter 22: Burnout and resiliency - p. 2256 249. Chapter 23: Structure and function of the heart - p. 2257 250. Chapter 24: Regional and peripheral circulation - p. 2260 251. Chapter 25: Endothelium and endotheliopathy - p. 2263 252. Chapter 26: Principles of invasive cardiovascular monitoring - p. 2265 253. Chapter 27: Assessment of cardiovascular function - p. 2267 254. Chapter 28: Cardiac failure and ventricular assist devices - p. 2271 255. Chapter 29: Echocardiographic imaging - p. 2272 256. Chapter 30: Diagnostic and therapeutic cardiac catheterization - p. 2274 257. Chapter 31: Pharmacology of the cardiovascular system - p. 2277 258. Chapter 32: Cardiopulmonary interaction - p. 2282 259. Chapter 33: Disorders of cardiac rhythm - p. 2284 260. Chapter 34: Shock states - p. 2284 261. Chapter 35: Pediatric cardiopulmonary bypass - p. 2286 262. Chapter 36: Critical care after surgery for congenital cardiac disease - p. 2287 263. Chapter 37: Cardiac transplantation - p. 2289 264. Chapter 38: Physiologic foundations of cardiopulmonary resuscitation - p. 2292 265. Chapter 39: Performance of cardiopulmonary resuscitation in infants and children - p. 2293 266. Chapter 40: Structure and development of the upper respiratory system - p. 2295 267. Chapter 41: Structure and development of the lower respiratory system - p. 2296 268. Chapter 42: Physiology of the respiratory system - p. 2297 269. Chapter 43: Noninvasive respiratory monitoring and assessment of gas exchange - p. 2297 270. Chapter 44: Overview of breathing failure - p. 2299 271. Chapter 45: Ventilation/perfusion inequality - p. 2301 272. Chapter 46: Mechanical dysfunction of the respiratory system - p. 2304 273. Chapter 47: Diseases of the upper respiratory tract - p. 2308 274. Chapter 48: Pediatric acute respiratory distress syndrome and ventilator-associated lung injury - p. 2309 275. Chapter 49: Acute viral bronchiolitis - p. 2311 276. Chapter 50: Asthma - p. 2312 277. Chapter 51: Neonatal pulmonary disease - p. 2314 278. Chapter 52: Pneumonitis and interstitial disease - p. 2315 279. Chapter 53: Diseases of the pulmonary circulation - p. 2317 280. Chapter 54: Mechanical ventilation and respiratory care - p. 2319 281. Chapter 55: Noninvasive ventilation in the pediatric intensive care unit - p. 2321 282. Chapter 56: Extracorporeal life support - p. 2323 283. Chapter 57: Pediatric lung transplantation - p. 2325 284. Chapter 58: Structure, function, and development of the nervous system - p. 2326 285. Chapter 59: Critical care considerations for common neurosurgical conditions - p. 2327 286. Chapter 60: Neurologic assessment and monitoring - p. 2328 287. Chapter 61: Neuroimaging - p. 2330 288. Chapter 62: Coma and depressed sensorium - p. 2331 289. Chapter 63: Intracranial hypertension and monitoring - p. 2335 290. Chapter 64: Status epilepticus - p. 2335 291. Chapter 65: Anoxic ischemic encephalopathy - p. 2338 292. Chapter 66: Pediatric stroke and intracerebral hemorrhage - p. 2343 293. Chapter 67: Central nervous system infections and related conditions - p. 2343 294. Chapter 68: Acute neuromuscular disease and disorders - p. 2346 295. Chapter 70: Renal structure and function - p. 2350 296. Chapter 71: Fluid and electrolyte issues in pediatric critical illness - p. 2352 297. Chapter 72: Acid-base balance in critical illness - p. 2353 298. Chapter 73: Tests of kidney function in children - p. 2355 299. Chapter 74: Glomerulotubular dysfunction and acute kidney injury - p. 2357 300. Chapter 75: Pediatric renal replacement therapy in the intensive care unit - p. 2359 301. Chapter 76: Pediatric renal transplantation - p. 2359 302. Chapter 77: Renal pharmacology - p. 2359 303. Chapter 78: Hypertensive urgencies and emergencies - p. 2360 304. Chapter 79: Cellular respiration - p. 2362 305. Chapter 80: Biology of the stress response - p. 2364 306. Chapter 81: Inborn errors of metabolism - p. 2365 307. Chapter 82: Genetic variation in health and disease - p. 2365 308. Chapter 83: Molecular foundations of cellular injury - p. 2367 309. Chapter 84: Endocrine emergencies - p. 2368 310. Chapter 85: Diabetic ketoacidosis - p. 2369 311. Chapter 86: Structure and function of the hematopoietic organs - p. 2371 312. Chapter 87: The erythron - p. 2373 313. Chapter 88: Hemoglobinopathies - p. 2374 314. Chapter 89: Coagulation and coagulopathy - p. 2377 315. Chapter 90: Thrombosis in pediatric critical care - p. 2379 316. Chapter 91: Transfusion medicine - p. 2379 317. Chapter 92: Hematology and oncology problems - p. 2380 318. Chapter 93: Critical illness in children undergoing hematopoietic progenitor cell transplantation - p. 2383 319. Chapter 94: Gastrointestinal structure and function - p. 2386 320. Chapter 95: Disorders of the gastrointestinal system - p. 2387 321. Chapter 96: Acute liver failure - p. 2390 322. Chapter 97: Hepatic transplantation - p. 2392 323. Chapter 98: Acute abdomen - p. 2393 324. Chapter 99: Nutrition of the critically ill child - p. 2394 325. Chapter 100: Innate immunity - p. 2395 326. Chapter 101: Adaptive immunity - p. 2400 327. Chapter 102: Critical illness and the microbiome - p. 2400 328. Chapter 103: Congenital immunodeficiencies - p. 2400 329. Chapter 104: Acquired immune dysfunction - p. 2402 330. Chapter 105: Immune balance in critical illness - p. 2404 331. Chapter 106: Pediatric rheumatologic disease - p. 2405 332. Chapter 107: Bacterial and fungal infections - p. 2407 333. Chapter 108: Life-threatening viral diseases and their treatment - p. 2408 334. Chapter 109: Healthcare-associated infections - p. 2410 335. Chapter 110: Pediatric sepsis - p. 2411 336. Chapter 111: Multiple organ dysfunction syndrome - p. 2413 337. Chapter 112: Bites and stings - p. 2414 338. Chapter 113: Hyperthermic injury - p. 2414 339. Chapter 114: Hypothermic injury - p. 2417 340. Chapter 115: Drowning - p. 2418 341. Chapter 116: Burn and inhalation injuries in children - p. 2421 342. Chapter 117: Evaluation, stabilization, and initial management after trauma - p. 2424 343. Chapter 118: Traumatic brain injury - p. 2424 344. Chapter 119: Pediatric thoracic trauma - p. 2427 345. Chapter 120: Pediatric abdominal trauma - p. 2428 346. Chapter 121: Child abuse - p. 2430 347. Chapter 122: Principles of drug disposition - p. 2430 348. Chapter 123: Molecular mechanisms of drug action - p. 2431 349. Chapter 124: Adverse drug reactions and drug-drug interactions - p. 2433 350. Chapter 125: Principles of toxin assessment and screening - p. 2434 351. Chapter 126: Toxidromes and their treatment - p. 2436 352. Chapter 127: Airway management - p. 2438 353. Chapter 128: Anesthesia effects on organ systems - p. 2439 354. Chapter 129: Anesthesia principles and operating room anesthesia regimens - p. 2440 355. Chapter 130: Malignant hyperthermia - p. 2442 356. Chapter 131: Neuromuscular blocking agents - p. 2443 357. Chapter 132: Sedation and analgesia - p. 2445 358. Chapter 133: Tolerance, dependency, and withdrawal - p. 2449 359. Chapter 134: Pediatric delirium - p. 2450 360. Chapter 135: Procedural sedation for the pediatric intensivist - p. 2450 361. Index - p. 2451
