Principles of toxin assessment and screening
• Poisoned patients are frequently encountered in the intensive care setting and often pose a diagnostic challenge. Skills in taking a history and performing a thorough physical exam, as well…
Accidental hypothermia
• Accidental or unintentional hypothermia is a potentially lethal complication of exposure to cold. It can occur as a result of exposure to cold air, water immersion/submersion, or snow burial….
Immune balance in critical illness
Pearls • The inflammatory response to critical illness is highly dynamic over time, involves both innate and adaptive immunity, and includes both pro- and antiinflammatory features. • These features constitute…
Adverse drug reactions and drug-drug interactions
Pearls • Adverse drug events (ADEs) are defined as any injury resulting from both prescribed and unintended administration of drugs, including inappropriate use or inadvertent side effects not associated with…
Congenital immunodeficiency
• Greater than 300 single-gene defects have now been associated with specific immunodeficiencies, with new disorders continually being recognized. • Chronic granulomatous disease is the most frequently diagnosed phagocytic cell…
Critical illness and the microbiome
• Like all organisms, humans have evolved in concert with microbes that serve numerous physiologic and immune functions during normal development and homeostasis. • Critical illness in both children and…
Endocrine emergencies
Pearls • Cortisol is a key mediator of the stress response—influencing immunity, metabolism, and modulating the transcription of perhaps 25% of the entire genome. • Relative adrenal insufficiency and critical…
Multiple-organ dysfunction syndrome
• Pediatric multiple-organ dysfunction syndrome (MODS) represents the leading final pathway to death in children who suffer critical illness triggered by acute insults such as sepsis (leading cause of MODS),…
Hepatic transplantation
Pearls • Liver transplantation (LT) has become the standard of care for children with end-stage or metabolic liver disease, acute liver failure, and unresectable liver tumors, with most common indication…
