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,…
Acute liver failure
• Pediatric acute liver failure represents a large number of heterogenous etiologies. • Effective diagnosis requires a systemic approach; however, despite thorough workup, in a large proportion of cases, cause…
Acute abdomen
• The abdomen is both a primary source of disease conditions that require care in the intensive care unit (ICU) and, frequently, a secondary source of additional pathophysiology for children…
Structure and function of the hematopoietic organs
• Normal ranges for blood cell numbers are dependent on age, gender, and race. • Because the bone marrow circulation connects with the general circulation, fluids and medications injected into…
