Hypoxic-ischemic encephalopathy
Pearls • Cardiac arrest in pediatric patients is predominantly due to asphyxia. This is in contrast to adults, for whom, despite an increase in asphyxial cardiac arrest related to the…
Procedural sedation for the pediatric intensivist
In the last 2 decades, there has been a robust demand for outpatient pediatric procedural sedation, now provided by myriad pediatric subspecialists, including pediatric intensivists. , The intensivist who is…
Tolerance, dependency, and withdrawal
• Physical dependency and withdrawal have been documented in all agents used for sedation and analgesia in the pediatric intensive care unit, including benzodiazepines, barbiturates, opioids, dexmedetomidine, propofol, and the…
Neuromuscular blocking agents
• Through the blockade of skeletal muscle function, neuromuscular blocking agents (NMBAs) cause cessation of respiratory function, mandating airway control and the institution of mechanical ventilation. NMBAs should not be…
Anesthesia principles and operating room anesthesia regimens
• The preoperative evaluation, which is performed prior to any anesthetic intervention, includes a history of present illness; past medical problems, including medication allergies; a past surgical and anesthetic history;…
Critical illness in children undergoing hematopoietic progenitor cell transplantation
• Outcomes for allogeneic hematopoietic cell transplant (HCT) patients requiring intensive care unit care have improved over the past 2 decades. • Both acute and late cardiac complications occur in…
Pediatric thoracic trauma
• Because of increased bone elasticity, rib fractures are uncommon in children and indicate significant traumatic energy delivery, raising concern for injuries of underlying viscera or nonaccidental trauma. • Children…
Renal structure and function
Pearls • Development of the definitive human kidney or metanephros begins at 5 weeks’ gestation and is complete by 34 to 36 weeks’ gestation, with an average of 1 million…
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….
