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…
The erythron
Pearls • Together, red blood cells (RBCs) at each stage of development may be considered an organ (termed the erythron ) now appreciated to participate in active regulation of regional…
Diabetic ketoacidosis
• Diabetic ketoacidosis (DKA) results either from absolute insulin deficiency or from relative insulin deficiency in the setting of high levels of counterregulatory hormones stimulated by infection or other illness….
Pediatric stroke and intracerebral hemorrhage
Pearls • Childhood stroke includes arterial ischemic stroke, cerebral sinus venous thrombosis, and intracranial hemorrhage. • Diagnosis of acute stroke in childhood is often delayed owing to failure to detect…
