Pediatric renal transplantation
Pearls • Kidney transplantation is the treatment of choice for children with end-stage renal disease; children have high priority in the deceased donor allocation policy. • Upon arrival in the…
Mechanical ventilation and respiratory care
Pearls • Modern respiratory care requires a major institutional commitment in resource allocation for state-of the-art management of the pediatric patient requiring mechanical ventilation. • A comprehensive and unified approach…
Structure, function, and development of the nervous system
Pearls • In humans, general central nervous system anatomy is established by birth. However, the brain undergoes substantial postnatal development, including changes in synaptic density and dendritic arborization, maturation of…
Neurologic assessment and monitoring
Pearls • Much of the practice of brain-directed critical care in children is empiric, but studies in traumatic brain injury show that protocol-directed care with multidisciplinary teams in the intensive…
Status epilepticus
Pearls • A seizure is a paroxysmal central nervous system disorder resulting from excessive hypersynchronous discharge of cortical neurons. • Status epilepticus is a common pediatric neurologic emergency that requires…
Critical care considerations for common neurosurgical conditions
Pearls • Hydrocephalus is a common brain disease characterized by a buildup of cerebrospinal fluid within the brain, causing elevated intracranial pressure. Untreated hydrocephalus can be a medical emergency, requiring…
Acid-base disorders
Pearls • Abnormalities in acid-base balance should be anticipated in all critically ill children due to their underlying disease or intensive care unit therapy and should be monitored closely. •…
Fluid and electrolyte issues in pediatric critical illness
Pearls • Hypotonic maintenance intravenous (IV) fluids are associated with mild to moderate hyponatremia in postoperative patients. Anesthesia, stress, and inflammatory mediators may contribute. Electrolyte monitoring in patients at risk…
Acute neuromuscular disease and disorders
Pearls • Common causes of acute flaccid paralysis in childhood include Guillain-Barré syndrome (GBS), acute flaccid myelitis, botulism, tick paralysis, periodic paralyses, and organophosphate poisoning. • Risk factors for respiratory…
Ventilation/perfusion inequality
Pearls • Gas exchange is optimized when pulmonary perfusion (Q) and alveolar ventilation (V A ) are tightly matched. The fractal design of the lung and gravitational effects on the…
