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…
Adverse drug reactions and drug-drug interactions
Pearls • Adverse drug events (ADEs) are defined as any injury resulting from both prescribed and unintended administration of drugs, including inappropriate use or inadvertent side effects not associated with…
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….
Immune balance in critical illness
Pearls • The inflammatory response to critical illness is highly dynamic over time, involves both innate and adaptive immunity, and includes both pro- and antiinflammatory features. • These features constitute…
Congenital immunodeficiency
• Greater than 300 single-gene defects have now been associated with specific immunodeficiencies, with new disorders continually being recognized. • Chronic granulomatous disease is the most frequently diagnosed phagocytic cell…
Critical illness and the microbiome
• Like all organisms, humans have evolved in concert with microbes that serve numerous physiologic and immune functions during normal development and homeostasis. • Critical illness in both children and…
Endocrine emergencies
Pearls • Cortisol is a key mediator of the stress response—influencing immunity, metabolism, and modulating the transcription of perhaps 25% of the entire genome. • Relative adrenal insufficiency and critical…
Multiple-organ dysfunction syndrome
• Pediatric multiple-organ dysfunction syndrome (MODS) represents the leading final pathway to death in children who suffer critical illness triggered by acute insults such as sepsis (leading cause of MODS),…
