Disorders and diseases of the gastrointestinal system
• So much reliance is placed on electronic monitoring of patients that physicians are often tempted to perform only a cursory examination or go days without laying hands on the…
Bacterial and fungal infections
• Emergence of resistant organisms is increasing in critically ill patients, requiring clinicians to use alternative drug and dosing strategies and to become familiar with institutional-specific resistance profiles. • Infectious…
Hyperthermic injury
• According to the Centers for Disease Control and Prevention, from 1999 to 2010, 7415 deaths were attributable to excessive heat exposure or hyperthermia in the United States. • With…
Transfusion medicine
• The decision to prescribe the transfusion of any blood product must be based on individualized indications and must take into account specific health problems. • Acute severe anemia (hemoglobin…
Healthcare-associated infections
• Hand hygiene is foundational to infection control in the pediatric intensive care unit (PICU), including the prevention of healthcare-associated infections (HAIs); units should be relentless in pursuing compliance with…
Life-threatening viral diseases and their treatment
• Clinicians should obtain serum to store for future serologic testing when viral pathogens are considered as the potential cause of a critical illness. • Multiplex polymerase chain reaction panels…
Thrombosis in pediatric critical care
• Vascular access devices are the most common cause of thromboembolic disease in children; thus, every attempt should be made to limit their use based on real clinical need. •…
Acquired immune dysfunction
• Most patients admitted to the pediatric intensive care unit are immunosuppressed to varying degrees. • Secondary immune dysfunction happens because of dysregulation between proinflammatory and antiinflammatory responses that fail…
Hematology and oncology problems
• Proactive treatment measures for tumor lysis syndrome include hydration with hypotonic or isotonic saline solution; alkalinization; use of allopurinol or urate oxidase; avoidance of exogenous potassium; close monitoring of…
Molecular foundations of cellular injury
• Cell death is an important physiologic homeostatic mechanism critical for host survival. • Regulated cell death pathways are evolutionarily conserved processes and include caspase-dependent (apoptosis, pyroptosis) and caspase-independent (necroptosis,…
