Structure and development of the lower respiratory system
Pearls • Lungs increase in volume from about 250 mL at birth to 6000 mL in the adult. • Each lung lobe is subdivided into 19 bronchopulmonary segments, which receive…
Physiologic foundations of cardiopulmonary resuscitation
Pearls • Both the cardiac and thoracic pump mechanisms play a role in infants and children during cardiopulmonary resuscitation. Thus, attention to excellent chest compression technique—with an emphasis on “push…
Disorders of cardiac rhythm
Pearls • Arrhythmias may result from ongoing therapies; ask, “What’s the DEAL?” ( d rugs and drips, e lectrolytes, a irway and acid-base, l ines). • Appropriate diagnosis is key….
Pediatric cardiopulmonary bypass
Pearls • Cardiopulmonary bypass (CPB), which originated in the mid-twentieth century, was designed to allow for the repair of congenital heart defects. Its history has since been characterized by perpetual…
Cardiac transplantation
Pearls • Most pediatric transplantations are performed for cardiomyopathy or congenital heart disease not amenable to correction or palliation. • Individuals may have a good quality of life following heart…
Critical care after surgery for congenital cardiac disease
Pearls • The neonatal myocardium is less compliant than that of the older child, less tolerant of increases in afterload, and less responsive to increases in preload. A predictable decrease…
Cardiopulmonary interactions
Pearls • Positive-pressure ventilation (PPV) alters ventricular loading conditions and compliance. • In patients who are hypovolemic, the effects of positive airway pressure on the right heart predominate, whereas in…
Shock states
The clinical syndrome of shock is one of the most dramatic, dynamic, and life-threatening problems faced by the physician in the critical care setting. Although untreated shock is universally lethal,…
Pharmacology of the cardiovascular system
Pearls • Clinical acumen and knowledge of physiology is needed to distinguish between the need for an inotropic agent, which is used to increase cardiac contractility, and the need for…
Echocardiographic imaging
Pearls • The intensive care unit is a unique environment for performing an echocardiogram; the intensivist, sonographer, and pediatric cardiologist must work together to obtain the needed information with minimal…
