Adaptive immunity
• Unlike the innate immune response, the adaptive immune response is characterized by specific antigen recognition and immunologic memory. • Lymphocytes are the key cell types of the adaptive immune…
Nutrition of the critically ill child
• Provision of individually tailored optimal nutrition is an important goal of pediatric critical care. • Malnutrition is prevalent in the pediatric intensive care unit (PICU) and is associated with…
Malignant hyperthermia
• Risk factors for malignant hyperthermia (MH) include a family history of severe hyperthermia or sudden hypermetabolic state during anesthesia with exposure to succinylcholine and/or potent inhalation anesthetics, and ryanodine…
Central nervous system infections and related conditions
Pearls • The classic triad of fever, neck stiffness, and a change in mental status is present in less than 50% of pediatric meningitis cases. • Streptococcus species (particularly viridans…
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…
