Roger's Textbook of Pediatric Intensive Care

1. Section I ■ Introduction to the Practice of Pediatric Critical Care - p. 3 2. Chapter 1 Pediatric Intensive Care: A Global Perspective - p. 3 3. INTRODUCTION - p. 3 4. IMPROVEMENT IN GLOBAL CHILD HEALTH OVER THE LAST FEW DECADES - p. 3 5. CAUSES OF GLOBAL CHILD MORTALITY - p. 4 6. THE WORLD HEALTH ORGANIZATION APPROACH TO IMPROVING THE QUALITY OF HOSPITAL CARE FOR CHILDREN - p. 4 7. ETHICS OF PROVIDING PEDIATRIC INTENSIVE CARE IN LOW- AND MIDDLE-INCOME COUNTRIES - p. 6 8. EXPERIENCES OF PEDIATRIC INTENSIVE CARE IN LOW- AND MIDDLE-INCOME COUNTRIES - p. 7 9. THE ROLE OF PEDIATRIC INTENSIVE CARE IN COMPLEX EMERGENCIES AND THE LESSONS LEARNED FROM COVID-19 - p. 7 10. THE STATE OF THE WORLD’S CHILDREN - p. 8 11. CONCLUSION - p. 9 12. Chapter 2 Impact of Pediatric Critical Care on the Family, Community, and Society - p. 11 13. PATIENT-CENTERED AND FAMILY-PARTNERED CARE - p. 11 14. RECOVERY AND REINTEGRATION AFTER CRITICAL ILLNESS - p. 14 15. PREPARING FOR AND RESPONDING TO DEATH - p. 17 16. RESILIENCE IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 18 17. THE ROLE OF THE PEDIATRIC CRITICAL CARE PROFESSIONAL IN SOCIETY - p. 20 18. CONCLUSIONS AND FUTURE DIRECTIONS - p. 21 19. ACKNOWLEDGMENTS - p. 21 20. Section II ■ Professionalism, Leadership, and Systems-Based Practice - p. 24 21. Chapter 3 Diversity, Equity, and Inclusion - p. 24 22. INTRODUCTION - p. 24 23. COMPOSITIONAL DIVERSITY OF THE PEDIATRIC CRITICAL CARE MEDICINE WORKFORCE - p. 24 24. PATIENT-LEVEL DIVERSITY, EQUITY, AND INCLUSION - p. 25 25. THE FIERCE URGENCY OF NOW - p. 25 26. CONCLUSION - p. 26 27. Chapter 4 Professionalism and Leadership in Pediatric Critical Care - p. 27 28. PROFESSIONALISM - p. 27 29. LEADERSHIP - p. 29 30. CONCLUSIONS AND FUTURE DIRECTIONS - p. 30 31. Chapter 5 Simulation Training and Team Dynamics - p. 34 32. INTRODUCTION - p. 34 33. SIMULATION TRAINING - p. 34 34. TEAMWORK DYNAMICS - p. 42 35. SIMULATION-BASED TEAM TRAINING - p. 43 36. CONCLUSIONS AND FUTURE DIRECTIONS - p. 44 37. Chapter 6 Pediatric Intensive Care Unit Organization and Physical Design - p. 48 38. HISTORY OF PEDIATRIC INTENSIVE CARE UNIT - p. 48 39. REGIONALIZATION OF PEDIATRIC CRITICAL CARE SERVICES - p. 49 40. PEDIATRIC INTENSIVE CARE UNIT LEVELS OF CARE - p. 50 41. PEDIATRIC INTENSIVE CARE UNIT POPULATION - p. 50 42. PEDIATRIC INTENSIVE CARE UNIT PERSONNEL AND STAFFING MODELS - p. 51 43. PHYSICAL DESIGN - p. 56 44. CONCLUSIONS AND FUTURE DIRECTIONS - p. 59 45. Chapter 7 Practice Management: The Business of Pediatric Critical Care - p. 63 46. INTRODUCTION - p. 63 47. PERSONNEL MANAGEMENT (HUMAN RESOURCES) - p. 63 48. FINANCE - p. 64 49. PRODUCTIVITY AND PERFORMANCE - p. 68 50. CONCLUSIONS AND FUTURE DIRECTIONS - p. 68 51. Chapter 8 Research Design and Statistical Analysis - p. 70 52. INTRODUCTION - p. 70 53. STUDY DESIGN - p. 70 54. STATISTICAL ANALYSIS - p. 76 55. REPORTING RESULTS - p. 87 56. COLLABORATIVE RESEARCH NETWORKS AND PLATFORMS - p. 87 57. RESEARCH TRAINING - p. 87 58. CONCLUSIONS AND FUTURE DIRECTIONS - p. 87 59. ACKNOWLEDGMENT - p. 88 60. Chapter 9 Evidence-Based Medicine - p. 91 61. CASE SCENARIOS - p. 91 62. INTRODUCTION - p. 91 63. GETTING STARTED: THE CLINICAL QUESTION - p. 92 64. TYPES OF EVIDENCE 3 - p. 92 65. SEARCHING FOR THE EVIDENCE 4 - p. 93 66. APPRAISING AND APPLYING THE EVIDENCE - p. 94 67. CONCLUSIONS AND FUTURE DIRECTIONS - p. 99 68. Chapter 10 Quality Improvement, Patient Safety, and Medical Error - p. 101 69. INTRODUCTION - p. 101 70. DEFINITIONS - p. 101 71. MEDICAL ERROR: HUMAN ERROR AND SYSTEMS - p. 102 72. THE PEDIATRIC INTENSIVE CARE UNIT ENVIRONMENT - p. 103 73. ERROR PREVENTION: SAFETY CULTURE, REPORTING, SYSTEMS ANALYSIS, CONTINUOUS QUALITY IMPROVEMENT, AND TECHNOLOGY - p. 104 74. MEDICAL ERROR AND THE PEDIATRIC INTENSIVE CARE UNIT ENVIRONMENT - p. 106 75. QUALITY MANAGEMENT AND RESOURCE ALLOCATION - p. 107 76. LEGAL ISSUES AND QUALITY CONTROL IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 108 77. CONCLUSIONS AND FUTURE DIRECTIONS - p. 109 78. Section III ■ Information Management - p. 112 79. Chapter 11 Severity-of-Illness Measurement in Pediatric Critical Care Medicine: Foundations, Principles, Outcomes, and Applications - p. 112 80. INTRODUCTION - p. 112 81. HISTORICAL PERSPECTIVE - p. 112 82. FOUNDATIONS - p. 115 83. DATA - p. 115 84. EPIDEMIOLOGY - p. 115 85. STATISTICS - p. 116 86. PRINCIPLES FOR APPLYING SEVERITY-OF-ILLNESS MEASUREMENT - p. 117 87. APPLICATIONS - p. 118 88. SUMMARY - p. 118 89. FUTURE DIRECTIONS - p. 118 90. Chapter 12 Clinical Informatics and Communication Technology in Pediatric Critical Care - p. 121 91. INTRODUCTION - p. 121 92. THE DATA ECOSYSTEM IN HEALTH CARE - p. 121 93. CLINICAL DECISION SUPPORT SYSTEMS - p. 124 94. TELEMEDICINE - p. 125 95. THE ROLE OF INFORMATICS IN PATIENT SAFETY AND QUALITY OF CARE - p. 125 96. IMPLEMENTATION OF CLINICAL INFORMATICS TOOLS - p. 126 97. THE CLINICAL INFORMATICS PROFESSION - p. 127 98. PROFESSIONAL SOCIAL MEDIA AND THE GLOBAL PEDIATRIC CRITICAL CARE COMMUNITY - p. 128 99. THE FUTURE OF CLINICAL INFORMATICS AND COMMUNICATION TECHNOLOGY IN CRITICAL CARE - p. 130 100. ACKNOWLEDGMENT - p. 130 101. Chapter 13 Learning From Patient Data: Data Science for Critically Ill Children - p. 134 102. INTRODUCTION - p. 134 103. THE PROCESS OF DATA SCIENCE - p. 135 104. SIMPLE MACHINE LEARNING MODELS - p. 138 105. CLASSICAL MACHINE LEARNING MODELS - p. 138 106. DEEP LEARNING - p. 139 107. PERFORMANCE ASSESSMENT - p. 141 108. MODEL INTERPRETABILITY - p. 144 109. CONCLUSION - p. 144 110. Section IV ■ Ethical and Palliative Concerns in the Care of the Critically Ill - p. 147 111. Chapter 14 Palliative and End-of-Life Care in the Pediatric Intensive Care Unit - p. 147 112. INTRODUCTION - p. 147 113. LOCATION OF DEATH - p. 148 114. HOME AND HOSPICE SUPPORT - p. 148 115. PALLIATIVE CARE TEAMS - p. 149 116. PAIN AND SYMPTOM MANAGEMENT - p. 149 117. LIMITATIONS ON ICU INTERVENTIONS - p. 150 118. SUPPORT OF THE FAMILY - p. 151 119. MULTIDISCIPLINARY APPROACH AND SUPPORT OF THE STAFF - p. 152 120. BROADER PERSPECTIVE AND THE FUTURE - p. 152 121. Chapter 15 Pain and Sedation Management - p. 156 122. INTRODUCTION - p. 156 123. PAIN AND SEDATION ASSESSMENT - p. 157 124. PAIN AND SEDATION MANAGEMENT—GENERAL PRINCIPLES - p. 161 125. ANALGESICS IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 162 126. DRUG SELECTION - p. 164 127. LOCAL ANESTHETICS - p. 168 128. EPIDURAL ANESTHESIA/ANALGESIA - p. 170 129. SEDATIVES IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 171 130. INHALATIONAL ANESTHETICS - p. 178 131. THE CHALLENGING PATIENT - p. 178 132. WEANING OF OPIOIDS/SEDATIVES - p. 181 133. SLEEP IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 184 134. DELIRIUM IN THE PEDIATRIC INTENSIVE CARE UNIT 17 - p. 185 135. CONCLUSIONS AND FUTURE DIRECTIONS - p. 189 136. Chapter 16 Ethics in the Pediatric Intensive Care Unit - p. 194 137. ETHICS FRAMEWORKS AND LENSES - p. 194 138. ETHICS AND LAW - p. 195 139. MEDICAL DECISION-MAKING - p. 196 140. WITHHOLDING AND WITHDRAWING LIFE-SUSTAINING MEDICAL THERAPIES IN PEDIATRIC CRITICAL CARE - p. 198 141. ETHICAL CONSIDERATIONS IN EXTRACORPOREAL MEMBRANE OXYGENATION - p. 199 142. SPECIAL TOPICS IN CARDIAC CRITICAL CARE - p. 200 143. SPECIAL TOPICS IN NEUROETHICS - p. 200 144. JUSTICE CONSIDERATIONS IN THE INTENSIVE CARE UNIT - p. 201 145. PUBLIC HEALTH AND ETHICS IN PANDEMICS - p. 201 146. ORGAN DONATION - p. 203 147. SUMMARY AND FUTURE DIRECTIONS - p. 204 148. Chapter 17 Organ Donation - p. 207 149. INTRODUCTION - p. 208 150. HISTORY OF ORGAN DONATION - p. 208 151. ORGAN DONATION AFTER BRAIN DEATH (DONATION BY NEUROLOGIC DETERMINATION OF DEATH) - p. 209 152. ORGAN DONATION AFTER CIRCULATORY DETERMINATION OF DEATH - p. 210 153. EVALUATION OF DONOR ELIGIBILITY - p. 213 154. PHYSIOLOGIC CONSIDERATIONS AND MEDICAL MANAGEMENT OF THE PEDIATRIC ORGAN DONOR - p. 214 155. ORGAN RECOVERY AND SURVIVAL RATES - p. 224 156. IMPACT OF CORONAVIRUS PANDEMIC - p. 224 157. CONCLUSIONS AND FUTURE DIRECTIONS - p. 225 158. ACKNOWLEDGMENT - p. 225 159. Chapter 18 Early Mobilization and Acute Rehabilitation in Critically Ill Children - p. 228 160. INTRODUCTION AND LANDSCAPE OF ACUTE REHABILITATION IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 228 161. BASIC CONCEPTS OF PEDIATRIC ACUTE REHABILITATION - p. 229 162. WHY IS REHABILITATION IN THE PEDIATRIC INTENSIVE CARE UNIT IMPORTANT? - p. 229 163. GASTROINTESTINAL - p. 231 164. POST–INTENSIVE CARE SYNDROME - p. 231 165. OPTIMIZING REHABILITATION IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 231 166. INTERPROFESSIONAL COMPONENTS OF THE REHABILITATION TEAM - p. 231 167. KEY FACTORS IN ESTABLISHING A CULTURE OF MOBILITY - p. 233 168. REHABILITATION IN THE PEDIATRIC INTENSIVE CARE UNIT—GENERAL PRINCIPLES - p. 233 169. REHABILITATION CONTINUUM OF CARE - p. 235 170. SPECIAL CONSIDERATIONS/POPULATIONS FOR PEDIATRIC INTENSIVE CARE UNIT REHABILITATION - p. 236 171. CHRONIC CRITICAL ILLNESS/BASELINE FUNCTIONAL IMPAIRMENT/COMPLEX CARE - p. 238 172. CONCLUSIONS AND FUTURE DIRECTIONS - p. 239 173. Section V ■ Basic Science Concepts of Pediatric Critical Care - p. 242 174. Chapter 19 Omics and Critical Care - p. 242 175. GENOMICS - p. 242 176. EPIGENETICS - p. 243 177. TRANSCRIPTOMICS - p. 245 178. MICROBIOME - p. 247 179. PROTEOMICS - p. 249 180. METABOLOMICS AND LIPIDOMICS - p. 249 181. CONCLUSIONS AND FUTURE DIRECTIONS - p. 253 182. SUMMARY - p. 253 183. Chapter 20 Innate Immunity and Inflammation - p. 258 184. INTRODUCTION - p. 258 185. DEFINITIONS - p. 258 186. INNATE IMMUNE SENSING: RECOGNITION OF DANGER - p. 259 187. CELL-SPECIFIC INNATE 5 RESPONSES - p. 262 188. SOLUBLE COMPONENTS: COMPLEMENT - p. 264 189. DYSREGU LATION OF THE INNATE IMMUNE RESPONSE 6 - p. 265 190. EMERGING CONCEPTS IN INNATE IMMUNITY AND FUTURE DIRECTIONS - p. 267 191. SUMMARY - p. 268 192. ACKNOWLEDGMENT - p. 268 193. Chapter 21 Cellular Adaptations to Stress - p. 271 194. INTRODUCTION - p. 271 195. HYPOXIA - p. 272 196. OXIDATIVE STRESS/ANTIOXIDANT SYSTEMS - p. 273 197. PROTEIN-RELATED STRESS RESPONSES - p. 275 198. HEME OXYGENASE - p. 276 199. THE DNA DAMAGE RESPONSE - p. 278 200. FUNCTIONAL AND METABOLIC ALTERATION - p. 278 201. PRECONDITIONING, TOLERANCE, AND MEMORY - p. 279 202. CLINICAL CONSIDERATIONS - p. 280 203. FUTURE DIRECTIONS AND CONCLUSION - p. 280 204. Chapter 22 Shock, Ischemia, and Reperfusion Injury - p. 286 205. INTRODUCTION - p. 286 206. OXYGEN DELIVERY AND ACUTE CELLULAR OXYGEN DEFICIENCY - p. 287 207. DEFINITION AND CLASSIFICATION OF SHOCK - p. 287 208. CELLULAR AND MOLECULAR MECHANISMS OF INJURY - p. 287 209. LABORATORY TESTS AND BIOMARKERS - p. 299 210. CONCLUSIONS AND FUTURE DIRECTIONS - p. 300 211. Chapter 23 Pharmacology - p. 304 212. INTRODUCTION - p. 304 213. SCIENTIFIC FOUNDATIONS - p. 304 214. APPLICATION TO PEDIATRIC INTENSIVE CARE 3 - p. 309 215. CURRENT ISSUES SURROUNDING PHARMACOTHERAPY - p. 319 216. SUMMARY - p. 320 217. Chapter 24 Multiple Organ Dysfunction Syndrome - p. 323 218. 1 INTRODUCTION - p. 323 219. DEFINING MULTIPLE ORGAN DYSFUNCTION SYNDROME - p. 323 220. SCORING SYSTEMS 2 - p. 324 221. EPIDEMIOLOGY OF MULTIPLE ORGAN DYSFUNCTION SYNDROME - p. 330 222. PATHOPHYSIOLOGY OF MULTIPLE ORGAN DYSFUNCTION SYNDROME - p. 331 223. TREATMENT OF MULTIPLE ORGAN DYSFUNCTION SYSTEM - p. 335 224. CONCLUSIONS AND FUTURE DIRECTIONS - p. 336 225. PART TWO ■ EMERGENCY CARE AND ACUTE MANAGEMENT - p. 339 226. Section I ■ Initial Stabilization - p. 341 227. Chapter 25 Airway Management - p. 341 228. ANATOMY AND AIRWAY DEVELOPMENT - p. 341 229. INITIAL AIRWAY ASSESSMENT - p. 344 230. IDENTIFYING THE DIFFICULT AIRWAY - p. 345 231. BASIC AIRWAY MANAGEMENT - p. 345 232. ADVANCED AIRWAY MANAGEMENT - p. 347 233. MANAGEMENT OF THE DIFFICULT AIRWAY - p. 356 234. MANAGEMENT OF SPECIFIC PROBLEMS - p. 357 235. CONCLUSIONS AND FUTURE DIRECTIONS - p. 361 236. ACKNOWLEDGMENT - p. 362 237. Chapter 26 Cardiopulmonary Resuscitation - p. 366 238. INTRODUCTION - p. 366 239. DEFINING CARDIAC ARREST: FOUR PHASES - p. 366 240. EPIDEMIOLOGY OF PEDIATRIC CARDIAC ARREST - p. 367 241. INTERVENTIONS DURING THE PREARREST PHASE: PROTECT - p. 369 242. INTERVENTIONS DURING THE CARDIAC ARREST (“NO-FLOW”) PHASE AND CARDIOPULMONARY RESUSCITATION (“LOW-FLOW”) PHASE: PRESERVE AND RESUSCITATE - p. 370 243. THE POSTARREST PHASE: REGENERATE - p. 378 244. SUCCESSFUL RESUSCITATION SYSTEMS OF CARE - p. 381 245. HEALTH CARE DISPARITIES - p. 381 246. CONCLUSIONS - p. 381 247. Chapter 27 Stabilization and Transport - p. 386 248. INTRODUCTION - p. 386 249. HISTORICAL DEVELOPMENT OF PEDIATRIC TRANSPORT PROGRAMS - p. 386 250. TRANSPORT IN DEVELOPING COUNTRIES - p. 386 251. ORGANIZATION OF PEDIATRIC TRANSPORT SYSTEMS - p. 387 252. THE TRANSPORT ENVIRONMENT - p. 389 253. PATIENT CARE DURING TRANSPORT - p. 392 254. TRANSPORT CONSIDERATIONS FOR SPECIFIC POPULATIONS - p. 394 255. OUTCOMES - p. 397 256. CONCLUSIONS AND FUTURE DIRECTIONS - p. 399 257. Chapter 28 Invasive Procedures - p. 403 258. GENERAL APPROACH AND EVIDENCE FOR USING ULTRASOUND GUIDANCE - p. 403 259. PERIPHERAL VASCULAR ACCESS - p. 403 260. CENTRAL VENOUS CATHETERIZATION - p. 405 261. ULTRASOUND ASSISTANCE IN CENTRAL VENOUS CATHETER PLACEMENT - p. 408 262. INTRAOSSEOUS ACCESS - p. 408 263. ARTERIAL CATHETERIZATION - p. 410 264. TRANSPYLORIC FEEDING TUBE PLACEMENT - p. 414 265. ABDOMINAL PARACENTESIS - p. 416 266. TRANSURETHRAL BLADDER CATHETER PLACEMENT AND BLADDER PRESSURE MONITORING - p. 418 267. CONCLUSIONS AND FUTURE DIRECTIONS - p. 420 268. Chapter 29 Recognition and Initial Management of Shock - p. 424 269. INTRODUCTION - p. 424 270. CLASSIFICATION OF SHOCK - p. 424 271. PATHOPHYSIOLOGY - p. 424 272. ASSESSMENT - p. 426 273. MANAGEMENT 5 - p. 431 274. Chapter 30 Rapid Response Systems - p. 441 275. INTRODUCTION - p. 441 276. ORIGINS AND PREVALENCE OF PEDIATRIC RAPID RESPONSE SYSTEMS - p. 441 277. RAPID RESPONSE SYSTEM COMPONENTS - p. 441 278. SUMMARY AND FUTURE DIRECTIONS - p. 448 279. Section II ■ Environmental Crises - p. 451 280. Chapter 31 Multiple Trauma - p. 451 281. EPIDEMIOLOGY OF PEDIATRIC TRAUMA - p. 451 282. PEDIATRIC INJURIES: MECHANISMS AND PATTERNS - p. 452 283. PATHOPHYSIOLOGY - p. 454 284. INITIAL ASSESSMENT AND STABILIZATION - p. 456 285. SECONDARY SURVEY - p. 463 286. CRITICAL CARE MANAGEMENT - p. 465 287. CHILD ABUSE - p. 472 288. COMPLICATIONS - p. 473 289. CONCLUSIONS AND FUTURE DIRECTIONS - p. 474 290. Chapter 32 Drowning - p. 477 291. DEFINITION - p. 477 292. EPIDEMIOLOGY - p. 477 293. PREVENTION - p. 478 294. MECHANISM OF DROWNING AND PATHOPHYSIOLOGY - p. 478 295. MANAGEMENT - p. 479 296. OUTCOMES - p. 481 297. FUTURE DIRECTIONS - p. 482 298. SUMMARY - p. 482 299. ACKNOWLEDGMENTS - p. 482 300. Chapter 33 Burns and Smoke Inhalation - p. 484 301. EVALUATION OF THE PATIENT - p. 484 302. RESUSCITATION AND INITIAL MANAGEMENT - p. 485 303. WOUND CARE - p. 489 304. INFECTION - p. 491 305. HYPERMETABOLISM AND NUTRITION - p. 493 306. OUTCOME - p. 494 307. PSYCHOLOGICAL IMPACT - p. 494 308. REHABILITATION - p. 495 309. CONCLUSIONS AND FUTURE DIRECTIONS - p. 495 310. Chapter 34 Injury From Chemical, Biologic, Radiologic, and Nuclear Agents - p. 498 311. CHEMICAL AGENTS - p. 498 312. BIOTERRORISM/BIOLOGIC AGENTS - p. 501 313. RADIOLOGIC/NUCLEAR AGENTS - p. 505 314. CONCLUSIONS AND FUTURE DIRECTIONS - p. 506 315. Chapter 35 Mass Casualty Events - p. 509 316. BACKGROUND - p. 509 317. THE STATE OF PEDIATRIC EMERGENCY PREPAREDNESS - p. 510 318. PEDIATRIC DISASTER TRIAGE - p. 511 319. HOSPITAL RESPONSE TO MASS CASUALTY EVENTS - p. 511 320. BOMBINGS AND BLAST INJURIES - p. 514 321. CIVILIAN PUBLIC MASS SHOOTINGS - p. 517 322. CHEMICAL AND RADIOLOGIC MASS CASUALTY EVENTS - p. 518 323. PANDEMICS AS MASS CASUALTY INCIDENTS - p. 520 324. CONCLUSIONS AND FUTURE DIRECTIONS - p. 521 325. Chapter 36 Poisoning - p. 525 326. EPIDEMIOLOGY - p. 525 327. CLINICAL APPROACH TO THE POISONED CHILD - p. 525 328. MANAGEMENT - p. 529 329. TOXIDROMES - p. 533 330. FOCUSED REVIEW OF COMMON TOXINS - p. 536 331. HERBAL TOXICITY/NUTRITIONAL SUPPLEMENT TOXICITY - p. 542 332. CLUB DRUGS - p. 542 333. CONCLUSIONS AND FUTURE DIRECTIONS - p. 543 334. Chapter 37 Thermoregulation - p. 546 335. PHYSIOLOGY OF THERMOREGULATION - p. 546 336. HYPERTHERMIA - p. 546 337. CLINICAL FEATURES - p. 549 338. DIFFERENTIAL DIAGNOSIS - p. 550 339. LABORATORY EVALUATION - p. 550 340. COMPLICATIONS - p. 550 341. TREATMENT - p. 550 342. HYPERTHERMIA SYNDROMES - p. 552 343. HYPOTHERMIA - p. 554 344. CONCLUSIONS AND FUTURE DIRECTIONS - p. 560 345. Chapter 38 Envenomation Syndromes - p. 563 346. SNAKEBITE - p. 563 347. SPIDERBITE - p. 570 348. SCORPION STINGS - p. 574 349. BEE, WASP, AND ANT (HYMENOPTERA) STINGS - p. 575 350. TICK BITE - p. 577 351. JELLYFISH STINGS - p. 578 352. VENOMOUS FISH STINGS - p. 580 353. OCTOPUS BITE - p. 581 354. CONE SNAIL STING - p. 582 355. FISH AND SHELLFISH POISONOUS TO EAT - p. 582 356. CONCLUSIONS AND FUTURE DIRECTIONS - p. 585 357. Section III ■ Life-Support Technologies - p. 589 358. Chapter 39 Mechanical Ventilation - p. 589 359. INTRODUCTION - p. 590 360. PHYSIOLOGY OF MECHANICAL VENTILATION - p. 590 361. VENTILATOR CONTROLLERS - p. 590 362. MODES OF VENTILATION - p. 594 363. PATIENT-VENTILATOR ASYNCHRONY - p. 598 364. WHY ARE CHILDREN DIFFERENT? - p. 600 365. INDICATIONS FOR MECHANICAL VENTILATION - p. 600 366. APPROACH TO MECHANICAL VENTILATION BASED ON DISEASE STATE - p. 600 367. LUNG RECRUITMENT AND POSITIVE END-EXPIRATORY PRESSURE TITRATION STRATEGIES - p. 601 368. HIGH-FREQUENCY VENTILATION - p. 603 369. WEANING FROM MECHANICAL VENTILATORY SUPPORT - p. 605 370. CONCLUSIONS AND FUTURE DIRECTIONS - p. 608 371. Chapter 40 Inhaled Gases and Noninvasive Ventilation - p. 610 372. INTRODUCTION - p. 610 373. HUMIDIFICATION - p. 610 374. OXYGEN - p. 610 375. INHALED NITRIC OXIDE - p. 612 376. INHALED PROSTACYCLIN - p. 614 377. HELIUM-OXYGEN MIXTURES (HELIOX) - p. 615 378. INHALED BRONCHODILATOR THERAPY - p. 616 379. INHALATIONAL ANESTHETICS - p. 618 380. NONINVASIVE VENTILATION - p. 620 381. CONCLUSIONS AND FUTURE DIRECTIONS - p. 623 382. Chapter 41 Extracorporeal Life Support - p. 626 383. INTRODUCTION - p. 626 384. CIRCUIT COMPONENTS - p. 626 385. OTHER COMPONENTS - p. 629 386. PATIENT SELECTION - p. 629 387. SUPPORT MODES - p. 631 388. CANNULATION - p. 635 389. PHYSIOLOGY OF EXTRACORPORE7AL CIRCULATION - p. 636 390. CIRCUIT MANAGEMENT - p. 638 391. PATIENT MANAGEMENT - p. 640 392. COMPLICATIONS - p. 641 393. OUTCOMES FROM EXTRACORPOREAL LIFE SUPPORT - p. 642 394. ORGANIZATION - p. 642 395. CONCLUSIONS AND FUTURE DIRECTIONS - p. 643 396. Chapter 42 Extracorporeal Organ Support Therapy - p. 647 397. INTRODUCTION - p. 647 398. GENERAL CONCEPTS - p. 648 399. RENAL REPLACEMENT THERAPIES - p. 651 400. PERITONEAL DIALYSIS - p. 652 401. HEMODIALYSIS - p. 655 402. CONTINUOUS RENAL REPLACEMENT THERAPY - p. 657 403. THERAPEUTIC PLASMA EXCHANGE - p. 662 404. CONCLUSIONS AND FUTURE DIRECTIONS - p. 665 405. Chapter 43 Blood Products and Transfusion Therapy - p. 669 406. BRIEF HISTORY OF TRANSFUSIONS - p. 669 407. RED BLOOD CELL TRANSFUSION - p. 670 408. PLASMA - p. 676 409. PLATELETS - p. 678 410. GRANULOCYTES - p. 680 411. WHOLE BLOOD - p. 681 412. MASSIVE TRANSFUSIONS - p. 682 413. COMMON COMPLICATIONS OF BLOOD PRODUCT TRANSFUSIONS - p. 683 414. BLOOD BANKS AND ADMINISTRATION OF BLOOD PRODUCTS - p. 684 415. LIMITING BLOOD PRODUCT UTILIZATION - p. 685 416. NARRATIVE SUMMARY - p. 685 417. NARRATIVE FUTURE DIRECTIONS - p. 685 418. ACKNOWLEDGMENTS - p. 685 419. PART THREE ■ CRITICAL CARE ORGAN SYSTEMS - p. 689 420. Section I ■ Respiratory Disease - p. 691 421. Chapter 44 Respiratory Physiology - p. 691 422. PULMONARY GAS EXCHANGE - p. 691 423. GAS CHANNELS AND CO2 GAS EXCHANGE - p. 704 424. MECHANICS OF THE LUNG AND RESPIRATORY SYSTEM - p. 705 425. PULMONARY CIRCULATION - p. 712 426. RESPIRATORY CONTROL - p. 717 427. SUMMARY AND FUTURE DIRECTIONS - p. 720 428. Chapter 45 The Molecular Biology of Acute Lung Injury - p. 722 429. INTRODUCTION - p. 722 430. INJURY, INFLAMMATION, AND EDEMA FORMATION - p. 722 431. INFLAMMATORY MEDIATORS IN LUNG INJURY - p. 725 432. REGULATION OF THE ALVEOLAR-CAPILLARY BARRIER - p. 728 433. SURFACTANT BIOCHEMISTRY IN THE INJURED LUNG - p. 731 434. FIBROPROLIFERATION AND REPAIR IN THE INJURED LUNG - p. 731 435. THE MOLECULAR BIOLOGY OF COVID-19 LUNG DISEASE - p. 733 436. ACKNOWLEDGMENTS - p. 736 437. Chapter 46 Respiratory Monitoring - p. 740 438. 1 WHY MONITOR? - p. 740 439. PHYSICAL ASSESSMENT - p. 740 440. GUIDELINES AND PRINCIPLES - p. 741 441. PULSE OXIMETRY 3 - p. 743 442. TRANSCUTANEOUS MEASUREMENT OF GAS TENSION - p. 746 443. 5 CAPNOGRAPHY - p. 748 444. MONITORING RESPIRATORY MECHANICS 6 - p. 750 445. POINT-OF-CARE ULTRASOUND (POCUS) IN RESPIRATORY MONITORING 7 - p. 759 446. CONCLUSIONS AND FUTURE DIRECTIONS - p. 760 447. Chapter 47 Acute Severe Asthma - p. 763 448. INTRODUCTION - p. 763 449. DEFINITION - p. 763 450. EPIDEMIOLOGY - p. 763 451. MECHANISM OF DISEASE: CORE PATHOPHYSIOLOGY - p. 764 452. CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS - p. 765 453. CLINICAL MANAGEMENT - p. 767 454. OUTCOMES - p. 773 455. CONCLUSIONS AND FUTURE DIRECTIONS - p. 773 456. Chapter 48 Neonatal Respiratory Failure - p. 776 457. INTRODUCTION - p. 776 458. DEVELOPMENTALLY REGULATED DISORDERS: RESPIRATORY CONDITIONS ASSOCIATED WITH PREMATURE LUNG - p. 776 459. DISORDERS OF TRANSITION - p. 785 460. CONGENITAL LUNG ANOMALIES - p. 787 461. ACQUIRED DISEASE - p. 789 462. CONCLUSION AND FUTURE DIRECTIONS - p. 793 463. Chapter 49 Pneumonia and Bronchiolitis - p. 797 464. PNEUMONIA - p. 797 465. ACUTE BRONCHIOLITIS - p. 812 466. Chapter 50 Acute Lung Injury and the Acute Respiratory Distress Syndrome - p. 824 467. INTRODUCTION AND DEFINITION - p. 824 468. MECHANISM OF DISEASE: CORE PATHOPHYSIOLOGY - p. 832 469. CLINICAL PRESENTATION - p. 842 470. PRINCIPLES OF CLINICAL MANAGEMENT - p. 843 471. OUTCOMES - p. 858 472. CONCLUSION AND FUTURE DIRECTIONS - p. 859 473. SUMMARY - p. 859 474. Chapter 51 Chronic Respiratory Failure - p. 867 475. INTRODUCTION - p. 867 476. RESPIRATORY SYSTEM IN CHILDREN - p. 868 477. ACUTE RESPIRATORY FAILURE - p. 868 478. CHRONIC RESPIRATORY FAILURE - p. 868 479. DECISION TO INITIATE CHRONIC VENTILATORY SUPPORT - p. 870 480. CANDIDATES FOR HOME MECHANICAL VENTILATION - p. 871 481. PHILOSOPHY OF CHRONIC VENTILATORY SUPPORT - p. 872 482. MODALITIES OF HOME MECHANICAL VENTILATION - p. 872 483. HOSPITAL MANAGEMENT BEFORE DISCHARGE - p. 876 484. HOME MANAGEMENT OF THE VENTILATOR-ASSISTED CHILD - p. 878 485. OUTCOME - p. 879 486. CONCLUSIONS AND FUTURE DIRECTIONS - p. 879 487. Chapter 52 Sleep and Breathing - p. 882 488. INTRODUCTION - p. 882 489. RESPIRATORY CONTROL AND SLEEP - p. 882 490. OBSTRUCTIVE SLEEP APNEA SYNDROME - p. 883 491. SUDDEN INFANT DEATH SYNDROME - p. 886 492. BRIEF RESOLVED UNEXPLAINED EVENTS - p. 887 493. SLEEP IN THE INTENSIVE CARE UNIT - p. 888 494. FUTURE DIRECTIONS - p. 889 495. Section II ■ Neuromuscular Disease - p. 893 496. Chapter 53 Electrodiagnostic Techniques in Neuromuscular Disease - p. 893 497. INTRODUCTION - p. 893 498. SIGNAL RECORDING - p. 893 499. CONCLUSIONS AND FUTURE DIRECTIONS - p. 901 500. ACKNOWLEDGMENT - p. 901 501. Chapter 54 Acute Neuromuscular Disease - p. 903 502. INTRODUCTION - p. 904 503. REGULATION OF RESPIRATION - p. 904 504. RESPIRATORY MECHANICS - p. 904 505. EVALUATION OF RESPIRATORY DYSFUNCTION IN A PATIENT WITH A NEUROMUSCULAR DISORDER - p. 905 506. MANAGEMENT - p. 906 507. DIAGNOSTIC ENTITIES - p. 908 508. GUILLAIN-BARRÉ SYNDROME - p. 909 509. MYASTHENIA GRAVIS - p. 913 510. ACUTE INTERMITTENT PORPHYRIA - p. 918 511. INTENSIVE CARE UNIT–ACQUIRED WEAKNESS - p. 920 512. DIAPHRAGMATIC PALSY - p. 921 513. CONCLUSIONS AND FUTURE DIRECTION - p. 923 514. ACKNOWLEDGMENTS - p. 923 515. Chapter 55 Chronic Neuromuscular Disease - p. 926 516. INTRODUCTION - p. 926 517. RECOGNIZING A CHRONIC NEUROMUSCULAR DISORDER - p. 926 518. OVERVIEW OF CHRONIC NEUROMUSCULAR DISEASES - p. 927 519. CLINICAL MANAGEMENT IN INTENSIVE CARE - p. 930 520. ONGOING VENTILATORY SUPPORT - p. 932 521. QUALITY OF LIFE IN CHILDREN VENTILATED FOR CHRONIC NEUROMUSCULAR DISEASE - p. 934 522. CONCLUSIONS AND FUTURE DIRECTIONS - p. 935 523. ACKNOWLEDGMENTS - p. 935 524. Section III ■ Neurologic Disease - p. 936 525. Chapter 56 Developmental Neurobiology, Neurophysiology, and the Pediatric Intensive Care Unit - p. 936 526. INTRODUCTION - p. 936 527. CENTRAL NERVOUS SYSTEM DEVELOPMENT - p. 936 528. NEUROTRANSMITTER AND NEUROTROPHIN DEVELOPMENT - p. 941 529. SYNAPTIC AND BEHAVIORAL DEVELOPMENT - p. 945 530. NEUROIMMUNE INTERACTIONS IN BRAIN DEVELOPMENT - p. 945 531. CEREBROVASCULAR AND METABOLISM DEVELOPMENT AND FUNCTION - p. 946 532. BLOOD-BRAIN BARRIER AND CHOROID PLEXUS DEVELOPMENT - p. 949 533. CEREBROSPINAL FLUID DYNAMICS - p. 949 534. CONCLUSIONS AND FUTURE DIRECTIONS - p. 950 535. Chapter 57 Molecular Biology of Brain Injury - p. 953 536. INJURY RESPONSE IN THE IMMATURE BRAIN - p. 953 537. PATHWAYS AND APPLICATIONS TO PEDIATRIC INTENSIVE CARE - p. 954 538. MECHANISMS OF ENHANCED VULNERABILITY OF INJURED BRAIN - p. 970 539. DEVELOPMENT AND TRANSLATION OF NEW MOLECULAR MECHANISM-BASED THERAPIES - p. 970 540. CONCLUSIONS AND FUTURE DIRECTIONS - p. 971 541. ACKNOWLEDGMENTS - p. 971 542. Chapter 58 Evaluation of the Comatose Child - p. 977 543. INTRODUCTION - p. 977 544. DEFINITIONS - p. 977 545. ANATOMY - p. 978 546. ETIOLOGIES OF COMA - p. 978 547. EVALUATION OF THE COMATOSE CHILD - p. 979 548. CONCLUSIONS - p. 988 549. Chapter 59 Neurologic Monitoring - p. 990 550. INTRODUCTION - p. 990 551. SCIENTIFIC FOUNDATIONS - p. 990 552. ADVANCED ASSESSMENT OF INTRACRANIAL COMPLIANCE USING INTRACRANIAL PRESSURE MONITORING - p. 996 553. TRANSCRANIAL DOPPLER ULTRASONOGRAPHY - p. 996 554. CLINICAL CONTEXT OF TRANSCRANIAL DOPPLER IN PEDIATRIC CRITICAL CARE - p. 996 555. NONINVASIVE INTRACRANIAL PRESSURE MONITORING USING TRANSCRANIAL DOPPLER MONITORING - p. 996 556. ASSESSMENT OF AUTOREGULATION - p. 997 557. MONITORING BY NEAR-INFRARED SPECTROSCOPY - p. 998 558. CLINICAL CONTEXT OF NEAR-INFRARED SPECTROSCOPY IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 1000 559. ASSESSMENT OF AUTOREGULATION USING NEAR-INFRARED SPECTROSCOPY MONITORING - p. 1000 560. REGIONAL BRAIN TISSUE OXYGEN (PbtO2) MONITORING - p. 1000 561. MULTIMODALITY NEUROMONITORING - p. 1000 562. CLINICAL CONTEXT OF MULTIMODAL MONITORING IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 1000 563. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1001 564. Chapter 60 Neurologic Imaging - p. 1004 565. TECHNIQUES - p. 1004 566. SELECTED CLINICAL APPLICATIONS - p. 1007 567. FUTURE DIRECTIONS - p. 1018 568. Chapter 61 Neurosurgical and Neuroradiologic Critical Care - p. 1022 569. PROCEDURAL AND OPERATING ROOM CONSIDERATIONS - p. 1022 570. POSTOPERATIVE NEUROSURGICAL CARE - p. 1025 571. 4 SURGERY-SPECIFIC CONSIDERATIONS - p. 1029 572. Chapter 62 Head and Spinal Cord Trauma - p. 1037 573. INTRODUCTION - p. 1037 574. EPIDEMIOLOGY - p. 1037 575. HEAD INJURY PATTERNS - p. 1037 576. TYPES OF INTRACRANIAL INJURY - p. 1039 577. TRAUMATIC SPINAL CORD INJURY - p. 1042 578. INITIAL CLINICAL MANAGEMENT - p. 1043 579. INITIAL INVESTIGATIONS - p. 1051 580. NEUROCRITICAL CARE MONITORING OF INTRACRANIAL PRESSURE - p. 1054 581. NEUROCRITICAL CARE TREATMENTS 4 - p. 1056 582. SEIZURES AND ANTICONVULSANTS - p. 1059 583. POST-TRAUMATIC MENINGITIS AND FEVER - p. 1060 584. FLUIDS AND NUTRITION - p. 1060 585. HYPOTHALAMIC-PITUITARY DYSFUNCTION - p. 1060 586. OTHER ASPECTS OF TRAUMATIC BRAIN INJURY CARE - p. 1062 587. SPINAL CORD INJURY–DIRECTED THERAPIES - p. 1062 588. OUTCOMES AND PROGNOSIS OF BRAIN INJURY - p. 1062 589. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1063 590. ACKNOWLEDGEMENTS - p. 1064 591. Chapter 63 Abusive Head Trauma - p. 1069 592. BASICS OF AHT RESUSCITATION AND CARE - p. 1069 593. INTRODUCTION - p. 1069 594. EPIDEMIOLOGY - p. 1070 595. DIAGNOSIS - p. 1071 596. MANAGEMENT/TREATMENT - p. 1073 597. OUTCOMES - p. 1074 598. REPORTING AND LEGAL ISSUES - p. 1074 599. PREVENTION - p. 1074 600. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1075 601. Chapter 64 Status Epilepticus - p. 1078 602. INTRODUCTION - p. 1078 603. DEFINITION - p. 1078 604. CLASSIFICATION - p. 1079 605. EPIDEMIOLOGY - p. 1080 606. ETIOLOGIES - p. 1080 607. MECHANISM OF DISEASE - p. 1082 608. CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS - p. 1083 609. OUTCOMES - p. 1093 610. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1094 611. Chapter 65 Cerebrovascular Disease and Stroke - p. 1099 612. INTRODUCTION - p. 1099 613. PRESENTATION, EPIDEMIOLOGY, OUTCOME, AND COSTS - p. 1099 614. MECHANISM OF DISEASE - p. 1100 615. CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS - p. 1110 616. DISEASE-SPECIFIC THERAPIES - p. 1121 617. FUTURE DIRECTIONS - p. 1121 618. ACKNOWLEDGMENTS - p. 1122 619. Chapter 66 Hypoxic-Ischemic Encephalopathy - p. 1125 620. INTRODUCTION - p. 1126 621. CORE PATHOPHYSIOLOGY AND PATHOBIOLOGY - p. 1126 622. CLINICAL ASPECTS OF HYPOXIC-ISCHEMIC ENCEPHALOPATHY - p. 1132 623. CONCLUSIONS - p. 1139 624. ACKNOWLEDGMENTS - p. 1139 625. Chapter 67 Metabolic Encephalopathies in Children - p. 1144 626. EPIDEMIOLOGY AND MECHANISM OF DISEASES - p. 1144 627. DIAGNOSIS - p. 1150 628. MANAGEMENT - p. 1153 629. OUTCOMES - p. 1155 630. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1155 631. Chapter 68 The Determination of Brain Death - p. 1159 632. INTRODUCTION - p. 1159 633. PREREQUISITE CONDITIONS THAT MUST BE SATISFIED PRIOR TO BRAIN DEATH TESTING - p. 1160 634. CLINICAL EXAMINATION CRITERIA TO DETERMINE BRAIN DEATH - p. 1161 635. APNEA TESTING - p. 1163 636. ANCILLARY STUDIES USED TO ASSIST WITH THE DETERMINATION OF BRAIN DEATH - p. 1163 637. DETERMINATION OF BRAIN DEATH FOR TERM NEWBORNS (37 WEEKS’ GESTATION) TO 30 DAYS OF AGE - p. 1164 638. DIAGNOSTIC ERRORS AND DETERMINATION OF BRAIN DEATH - p. 1165 639. DETERMINATION OF BRAIN DEATH IN SPECIAL CIRCUMSTANCES - p. 1165 640. DOCUMENTATION AND DETERMINATION OF DEATH - p. 1166 641. SPECIAL CONSIDERATIONS - p. 1168 642. COMMUNICATION WITH FAMILIES - p. 1168 643. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1168 644. Section IV ■ Cardiovascular Disease - p. 1171 645. Chapter 69 Cardiac Anatomy - p. 1171 646. INTRODUCTION - p. 1171 647. SEGMENTAL APPROACH TO CONGENITAL HEART DISEASE - p. 1171 648. SYSTEMIC AND PULMONARY VENOUS CONNECTIONS - p. 1176 649. CARDIAC POSITION - p. 1176 650. CLINICAL EXAMPLES - p. 1176 651. CONGENITAL CARDIAC DEFECTS - p. 1177 652. FUTURE DIRECTIONS - p. 1184 653. Chapter 70 Cardiovascular Physiology - p. 1185 654. INTRODUCTION - p. 1185 655. CARDIOVASCULAR CIRCUIT AND VASCULAR ANATOMY - p. 1186 656. HEMODYNAMIC PRINCIPLES - p. 1186 657. INTERACTION OF THE CARDIAC PUMP AND THE VASCULATURE - p. 1187 658. REGULATION OF VASCULAR RESISTANCE - p. 1191 659. REGULATION OF REGIONAL CIRCULATIONS - p. 1194 660. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1200 661. Chapter 71 Cardiorespiratory Interactions in Children With Heart Disease - p. 1202 662. INTRODUCTION AND HISTORICAL PERSPECTIVE - p. 1202 663. INTRATHORACIC PRESSURE AND RIGHT VENTRICULAR PRELOAD - p. 1203 664. INTRATHORACIC PRESSURE AND RIGHT VENTRICULAR AFTERLOAD - p. 1205 665. INTRATHORACIC PRESSURE AND LEFT VENTRICULAR PRELOAD - p. 1205 666. INTRATHORACIC PRESSURE AND THE LEFT VENTRICULAR AFTERLOAD - p. 1206 667. CARDIORESPIRATORY INTERACTIONS IN CHILDREN WITH HEART DISEASE - p. 1207 668. CARDIORESPIRATORY INTERACTIONS IN CHILDREN WITH SYSTOLIC HEART FAILURE - p. 1207 669. CARDIORESPIRATORY INTERACTIONS IN CHILDREN WITH DIASTOLIC VENTRICULAR DYSFUNCTION - p. 1208 670. CARDIORESPIRATORY INTERACTIONS IN CHILDREN WITH CONGENITAL HEART DISEASE - p. 1208 671. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1211 672. Chapter 72 Hemodynamic Monitoring - p. 1214 673. INTRODUCTION - p. 1214 674. PHYSICAL EXAMINATION - p. 1214 675. ELECTROCARDIOGRAM - p. 1214 676. TECHNIQUE - p. 1214 677. INTERPRETATION - p. 1215 678. TECHNICAL FACTORS - p. 1215 679. CAPNOGRAPHY - p. 1215 680. PHYSIOLOGIC CONSIDERATIONS - p. 1215 681. ARTERIAL PRESSURE - p. 1215 682. NONINVASIVE OSCILLOMETRIC ARTERIAL PRESSURE MEASUREMENT - p. 1215 683. INVASIVE ARTERIAL PRESSURE MONITORING - p. 1216 684. PLACEMENT AND COMPLICATIONS - p. 1216 685. INTERPRETATION - p. 1217 686. CENTRAL VENOUS AND ATRIAL PRESSURES - p. 1217 687. PLACEMENT AND COMPLICATIONS - p. 1217 688. INTERPRETATION - p. 1218 689. LEFT ATRIAL PRESSURE MONITORING - p. 1218 690. PULMONARY ARTERIAL CATHETER - p. 1218 691. PLACEMENT AND COMPLICATIONS - p. 1219 692. INTERPRETATION OF THERMODILUTION-DERIVED CARDIAC OUTPUT - p. 1220 693. INTERPRETATION OF OTHER HEMODYNAMIC MEASUREMENTS FROM THE PULMONARY ARTERIAL CATHETER - p. 1221 694. FICK EQUATION AND INDIRECT CARDIAC OUTPUT MEASUREMENT - p. 1221 695. CALCULATION OF THE QP/QS RATIO - p. 1221 696. TECHNICAL FACTORS - p. 1221 697. PULSE CONTOUR ANALYSIS - p. 1221 698. TECHNICAL FACTORS - p. 1222 699. ECHOCARDIOGRAPHY - p. 1222 700. VENTRICULAR SHORTENING FRACTION AND EJECTION FRACTION - p. 1222 701. VENOUS OXIMETRY - p. 1223 702. BASIC PRINCIPLES - p. 1223 703. PHYSIOLOGY AND PATHOPHYSIOLOGY - p. 1223 704. COMPENSATORY CIRCULATORY RESPONSES TO MAINTAIN TISSUE OXYGENATION - p. 1223 705. CENTRAL VENOUS OXIMETRY - p. 1224 706. ADVANTAGES AND LIMITATIONS OF VENOUS OXIMETRY - p. 1224 707. CLINICAL APPLICATION AND CLINICAL STUDIES - p. 1225 708. CEREBRAL NEAR-INFRARED SPECTROSCOPY OXIMETRY - p. 1225 709. RENAL AND MESENTERIC NEAR-INFRARED SPECTROSCOPY OXIMETRY - p. 1225 710. LACTATE - p. 1226 711. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1226 712. Chapter 73 Heart Failure: Etiology, Pathophysiology, and Diagnosis - p. 1230 713. INTRODUCTION - p. 1230 714. ETIOLOGY - p. 1230 715. PATHOPHYSIOLOGY - p. 1232 716. CLASSIFICATION AND EVALUATION - p. 1234 717. SUMMARY AND FUTURE DIRECTIONS - p. 1237 718. Chapter 74 Cardiomyopathy, Myocarditis, and Mechanical Circulatory Support - p. 1241 719. INTRODUCTION - p. 1241 720. CARDIOMYOPATHIES - p. 1241 721. MYOCARDITIS - p. 1247 722. THERAPEUTIC STRATEGIES IN CHILDREN WITH CARDIOMYOPATHY OR MYOCARDITIS - p. 1251 723. MECHANICAL CIRCULATORY SUPPORT - p. 1255 724. SUMMARY - p. 1261 725. FUTURE DIRECTIONS - p. 1261 726. Chapter 75 Treatment of Heart Failure: Medical Management - p. 1267 727. INTRODUCTION - p. 1267 728. MANAGEMENT OF ACUTE DECOMPENSATED HEART FAILURE - p. 1267 729. DIAGNOSIS AND ASSESSMENT OF ACUTE DECOMPENSATED HEART FAILURE - p. 1268 730. HEART FAILURE IN CONGENITAL HEART DISEASE - p. 1273 731. HEART FAILURE WITH PRESERVED EJECTION FRACTION - p. 1274 732. MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN ASSOCIATED WITH COVID-19 - p. 1274 733. NEW MEDIA - p. 1275 734. Chapter 76 Treatment of Heart Failure: Mechanical Support - p. 1278 735. INTRODUCTION - p. 1278 736. HEART FAILURE IN CHILDREN - p. 1278 737. PATIENT SELECTION - p. 1279 738. DEVICE SELECTION - p. 1280 739. EXTRACORPOREAL MEMBRANE OXYGENATION - p. 1280 740. SHORT-TERM TEMPORARY VENTRICULAR ASSIST DEVICE IN PATIENTS WITH HEART FAILURE - p. 1282 741. LONG-TERM DURABLE VENTRICULAR ASSIST DEVICE - p. 1283 742. SPECIAL CONSIDERATIONS - p. 1284 743. CONCLUSION - p. 1286 744. Chapter 77 Thoracic Transplantation - p. 1289 745. CARDIAC TRANSPLANTATION - p. 1289 746. LUNG TRANSPLANTATION - p. 1296 747. Chapter 78 Cardiac Conduction, Dysrhythmias, and Pacing - p. 1303 748. INTRODUCTION - p. 1303 749. GUIDE TO INTERPRETATION OF ELECTROCARDIOGRAPHIC RECORDINGS - p. 1303 750. THE CARDIAC CONDUCTION SYSTEM - p. 1304 751. TACHYDYSRHYTHMIAS - p. 1304 752. SPECIFIC DIAGNOSIS - p. 1306 753. BRADYDYSRHYTHMIAS - p. 1321 754. PRINCIPLES OF TEMPORARY PACING - p. 1324 755. ANTIDYSRHYTHMIC DRUGS - p. 1325 756. CONCLUSION - p. 1328 757. Chapter 79 Preoperative Care of the Pediatric Cardiac Surgical Patient - p. 1331 758. INTRODUCTION - p. 1331 759. PATIENT DEMOGRAPHICS - p. 1331 760. NEWBORN CONSIDERATIONS - p. 1332 761. PREOPERATIVE MANAGEMENT AND CARE - p. 1333 762. PREOPERATIVE MANAGEMENT OF PATIENTS WITH A SINGLE VENTRICLE - p. 1338 763. PREOPERATIVE ENTERAL NUTRITION IN NEONATAL PATIENTS - p. 1339 764. RISK STRATIFICATION IN PEDIATRIC CARDIAC SURGERY - p. 1340 765. SUMMARY AND FUTURE DIRECTIONS - p. 1340 766. Chapter 80 Postoperative Care of the Pediatric Cardiac Surgical Patient - p. 1344 767. INTRODUCTION - p. 1344 768. CARDIOPULMONARY BYPASS - p. 1344 769. THE INFLAMMATORY RESPONSE TO CPB - p. 1345 770. GENERAL POSTOPERATIVE CONSIDERATIONS - p. 1347 771. RESPIRATORY FUNCTION, DYSFUNCTION, AND TREATMENT - p. 1350 772. NEUROLOGIC ISSUES - p. 1351 773. ENDOCRINE ISSUES - p. 1352 774. GASTROINTESTINAL ISSUES - p. 1353 775. HEMATOLOGIC ISSUES - p. 1353 776. INFECTIOUS ISSUES - p. 1354 777. RENAL ISSUES - p. 1354 778. LESION-SPECIFIC MANAGEMENT - p. 1355 779. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1363 780. Chapter 81 Pulmonary Hypertension - p. 1368 781. INTRODUCTION - p. 1368 782. CLASSIFICATION - p. 1368 783. EPIDEMIOLOGY - p. 1368 784. PATHOPHYSIOLOGY OF PULMONARY HYPERTENSION - p. 1369 785. DIAGNOSIS - p. 1370 786. TREATMENT - p. 1372 787. INVASIVE OPTIONS FOR REFRACTORY PULMONARY HYPERTENSION - p. 1375 788. PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN - p. 1375 789. SUMMARY - p. 1375 790. FUTURE DIRECTIONS - p. 1375 791. Section V ■ Immunologic Diseases - p. 1379 792. Chapter 82 The Immune System - p. 1379 793. INTRODUCTION - p. 1379 794. 1 THE IMMUNE SYSTEM - p. 1379 795. 2 COMPONENTS OF THE IMMUNE SYSTEM - p. 1380 796. SEPSIS IN CHILDREN 6 - p. 1386 797. FUTURE DIRECTIONS - p. 1391 798. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1392 799. Chapter 83 Neurohormonal Control in the Immune System - p. 1395 800. INTRODUCTION - p. 1395 801. THE NEUROHORMONAL RESPONSE TO ACUTE STRESS - p. 1395 802. RECENT NEUROENDOCRINE-IMMUNE MEDIATORS APPLIED TO CRITICAL ILLNESS - p. 1396 803. PATHWAYS OF COMMUNICATION - p. 1397 804. IMMUNE COMPETENCE AND FAILURE IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 1401 805. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1404 806. Chapter 84 The Polymorphonuclear Leukocyte in Critical Illness - p. 1407 807. INTRODUCTION - p. 1407 808. NEUTROPHIL PHYSIOLOGY - p. 1407 809. 4 DEFECTS IN NEUTROPHIL NUMBER AND/OR FUNCTION - p. 1415 810. NEUTROPHILS AND CRITICAL ILLNESS - p. 1416 811. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1418 812. Chapter 85 The Immune System and Viral Illness - p. 1422 813. INTRODUCTION - p. 1422 814. 1 VIRAL ILLNESS: A MAJOR CAUSE OF CRITICAL ILLNESS IN CHILDREN - p. 1422 815. MUCOSAL IMMUNITY: THE FIRST BARRIER TO VIRAL INVASION - p. 1423 816. 4 CIRCULATING MEDIATORS CONTRIBUTE TO EARLY ANTIVIRAL RESPONSES - p. 1427 817. INNATE CELLULAR IMMUNITY IN VIRAL INFECTION 5 - p. 1427 818. ADAPTIVE IMMUNITY IN VIRAL INFECTIONS - p. 1429 819. 8 FUTURE DIRECTIONS - p. 1434 820. SUMMARY - p. 1434 821. Chapter 86 Immune Modulation and Immunotherapy in Critical Illness - p. 1438 822. INTRODUCTION - p. 1438 823. TARGETING PRO-INFLAMMATION - p. 1438 824. IMMUNOPARALYSIS - p. 1440 825. PATIENTS WITH OVERT IMMUNOSUPPRESSION - p. 1442 826. INTRAVENOUS IMMUNOGLOBULIN - p. 1443 827. IMMUNONUTRITION - p. 1444 828. GENETIC INFLUENCES - p. 1444 829. IMPACT OF CRITICAL ILLNESS ON INFLAMMATION - p. 1444 830. SUMMARY - p. 1445 831. FUTURE DIRECTIONS - p. 1445 832. Chapter 87 Immune Deficiency Disorders - p. 1449 833. PRIMARY OR CONGENITAL IMMUNE DEFICIENCY DISORDERS - p. 1449 834. DISORDERS PREDOMINANTLY AFFECTING IMMUNOGLOBULINS - p. 1449 835. DISORDERS PREDOMINANTLY AFFECTING CELLULAR FUNCTION - p. 1454 836. IMMUNODEFICIENCY WITH CYTOTOXIC DEFECTS - p. 1454 837. IMMUNODEFICIENCY WITH COMBINED ANTIBODY AND CELLULAR DEFECTS - p. 1456 838. DISORDERS AFFECTING PHAGOCYTE FUNCTION - p. 1458 839. COMPLEMENT DEFICIENCY - p. 1460 840. INNATE IMMUNE SIGNALING DEFECTS - p. 1463 841. IMMUNODEFICIENCY AND CANCER PREDISPOSITION - p. 1463 842. IMMUNOLOGIC EFFECTS OF CANCER AND ITS TREATMENT - p. 1464 843. IMMUNE DYSFUNCTION ASSOCIATED WITH HEMATOPOIETIC STEM CELL TRANSPLANT - p. 1464 844. FUTURE DIRECTIONS - p. 1466 845. Section VI ■ Infectious Diseases - p. 1469 846. Chapter 88 Bacterial Sepsis - p. 1469 847. INTRODUCTION AND DEFINITION - p. 1469 848. MECHANISM OF DISEASE: CORE PATHOPHYSIOLOGY - p. 1474 849. CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS - p. 1476 850. CLINICAL MANAGEMENT/TREATMENT - p. 1478 851. PREVENTION OF SEPSIS - p. 1483 852. QUALITY IMPROVEMENT THROUGH BUNDLED MANAGEMENT ALGORITHMS - p. 1484 853. OUTCOMES - p. 1485 854. SUMMARY AND FUTURE DIRECTIONS - p. 1485 855. Chapter 89 Principles of Antimicrobial Therapy - p. 1490 856. INTRODUCTION - p. 1490 857. INITIATION OF EMPIRIC ANTIBIOTIC THERAPY AND LABORATORY CONSIDERATIONS IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 1491 858. DE-ESCALATION/DISCONTINUATION AND DEFINITIVE THERAPY - p. 1493 859. ANTIBIOTIC STEWARDSHIP STRATEGIES IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 1494 860. BIOMARKERS OF INFECTION - p. 1494 861. PHYSIOLOGIC CHANGES IN CRITICALLY ILL PATIENTS—IMPACT ON DOSING - p. 1495 862. APPLICATION OF PHARMACOKINETICS-PHARMACODYNAMICS - p. 1497 863. MODIFIED DOSING STRATEGIES - p. 1498 864. ANTIBACTERIAL AGENTS - p. 1499 865. ANTIFUNGAL AGENTS - p. 1509 866. ANTIVIRAL AGENTS (NON-HIV) - p. 1512 867. ANTIVIRAL AGENTS (INFLUENZA) - p. 1514 868. ANTI-INFECTIVES FOR MYCOBACTERIUM TUBERCULOSIS - p. 1514 869. ANTIMALARIAL DRUGS - p. 1515 870. Chapter 90 Dengue and Other Hemorrhagic Viral Infections - p. 1520 871. DENGUE INFECTIONS - p. 1520 872. PATHOGENESIS AND PATHOPHYSIOLOGY - p. 1521 873. CLINICAL MANIFESTATIONS AND NATURAL COURSE - p. 1523 874. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS - p. 1525 875. CONFIRMATION TESTS FOR DENGUE - p. 1526 876. MANAGEMENT - p. 1526 877. VOLUME REPLACEMENT - p. 1527 878. VIRAL HEMORRHAGIC FEVERS - p. 1532 879. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1534 880. Chapter 91 Critical Viral Infections - p. 1537 881. INTRODUCTION - p. 1537 882. SEVERE INFLUENZA INFECTIONS - p. 1538 883. HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN THE CRITICALLY ILL CHILD - p. 1540 884. MEASLES - p. 1548 885. NONPOLIO ENTEROVIRAL INFECTIONS - p. 1550 886. SEVERE VARICELLA INFECTIONS - p. 1551 887. SEVERE HERPES SIMPLEX VIRUS INFECTIONS - p. 1552 888. SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 - p. 1553 889. COVID-19 INFECTION (COVID-19) - p. 1553 890. MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN - p. 1555 891. Chapter 92 Central Nervous System Infections - p. 1560 892. INTRODUCTION - p. 1560 893. BACTERIAL MENINGITIS - p. 1563 894. ASEPTIC MENINGITIS - p. 1571 895. TUBERCULAR MENINGITIS - p. 1573 896. ENCEPHALITIS AND MYELITIS - p. 1577 897. HERPES ENCEPHALITIS - p. 1581 898. JAPANESE ENCEPHALITIS - p. 1583 899. CORONAVIRUS DISEASE 2019 NERVOUS SYSTEM INFECTION - p. 1584 900. ACUTE DISSEMINATED ENCEPHALOMYELITIS - p. 1585 901. BRAIN AND SPINAL CORD ABSCESS - p. 1587 902. SUBDURAL EMPYEMA - p. 1589 903. EPIDURAL ABSCESS - p. 1590 904. CEREBROSPINAL FLUID SHUNT INFECTION - p. 1591 905. FUNGAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM - p. 1592 906. PARASITIC INFECTIONS - p. 1598 907. NEUROCYSTICERCOSIS - p. 1600 908. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1603 909. ACKNOWLEDGMENTS - p. 1603 910. Chapter 93 Nosocomial Infections in the Pediatric Intensive Care Unit - p. 1607 911. DEFINITIONS - p. 1607 912. OVERVIEW AND EPIDEMIOLOGY - p. 1607 913. CATHETER-RELATED BLOODSTREAM INFECTIONS - p. 1612 914. DEFINITIONS - p. 1612 915. EPIDEMIOLOGY - p. 1612 916. NOSOCOMIAL RESPIRATORY INFECTIONS - p. 1617 917. NOSOCOMIAL URINARY TRACT INFECTIONS - p. 1623 918. NOSOCOMIAL GASTROINTESTINAL INFECTIONS - p. 1624 919. SURGICAL SITE INFECTIONS - p. 1624 920. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1625 921. Chapter 94 International and Emerging Infections - p. 1629 922. International Infections - p. 1630 923. EMERGING INFECTIONS - p. 1640 924. ACKNOWLEDGMENTS - p. 1642 925. Chapter 95 Toxin-Related Diseases - p. 1645 926. INTRODUCTION - p. 1645 927. TETANUS - p. 1645 928. DIPHTHERIA - p. 1653 929. BOTULISM - p. 1658 930. TOXIC SHOCK SYNDROME - p. 1662 931. CONCLUSION AND FUTURE DIRECTION - p. 1667 932. Chapter 96 Opportunistic Infections - p. 1670 933. INTRODUCTION - p. 1670 934. DEFECTS IN THE IMMUNE SYSTEM AND OPPORTUNISTIC PATHOGENS - p. 1670 935. APPROACH TO THE PATIENT WITH SUSPECTED OPPORTUNISTIC INFECTION - p. 1672 936. OPPORTUNISTIC INFECTIONS IN PEDIATRIC INTENSIVE CARE SETTINGS - p. 1672 937. OPPORTUNISTIC INFECTIONS DUE TO VIRUSES - p. 1672 938. FUNGAL INFECTIONS - p. 1676 939. MYCOBACTERIAL INFECTIONS - p. 1684 940. PARASITIC INFECTIONS - p. 1686 941. CRYPTOSPORIDIUM INFECTION - p. 1687 942. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1687 943. Section VII ■ Nutritional and Gastrointestinal Disorders - p. 1690 944. Chapter 97 Principles of Gastrointestinal Physiology, Nutrition, and Metabolism - p. 1690 945. INTRODUCTION - p. 1690 946. GASTROINTESTINAL TRACT ANATOMY AND PHYSIOLOGY - p. 1691 947. GUT AS AN IMMUNE SYSTEM - p. 1698 948. ENERGY EXPENDITURE AND METABOLISM - p. 1700 949. KEY NUTRIENTS - p. 1702 950. BODY COMPOSITION - p. 1706 951. ENTERAL VERSUS PARENTERAL NUTRITION - p. 1706 952. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1707 953. Chapter 98 Nutritional Support - p. 1711 954. NUTRITIONAL ASSESSMENT - p. 1711 955. HISTORY AND PHYSICAL EXAMINATION - p. 1711 956. ANTHROPOMETRIC EXAMINATION - p. 1711 957. NUTRITIONAL STATUS - p. 1712 958. NUTRITIONAL MANAGEMENT - p. 1714 959. NUTRITIONAL DELIVERY - p. 1718 960. NUTRITIONAL MONITORING - p. 1724 961. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1727 962. Chapter 99 Secretory and Motility Issues of the Gastrointestinal Tract - p. 1730 963. INTRODUCTION - p. 1730 964. DIARRHEA - p. 1730 965. ETIOLOGIES OF DIARRHEA IN ICU PATIENTS - p. 1730 966. EVALUATION AND MANAGEMENT - p. 1731 967. INTESTINAL HYPOMOTILITY (ILEUS) - p. 1732 968. MANAGEMENT - p. 1733 969. PROGNOSIS - p. 1734 970. GASTROESOPHAGEAL REFLUX - p. 1734 971. ETIOLOGY - p. 1734 972. MANAGEMENT - p. 1735 973. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1735 974. Chapter 100 Gastrointestinal Bleeding - p. 1739 975. INTRODUCTION AND EPIDEMIOLOGY - p. 1739 976. ANATOMIC LOCATION - p. 1739 977. DEFINITIONS AND CLINICAL PRESENTATION - p. 1739 978. ETIOLOGY - p. 1739 979. DIAGNOSTIC EVALUATION - p. 1739 980. MEDICAL MANAGEMENT - p. 1742 981. SPECIFIC CONDITIONS - p. 1745 982. SUMMARY AND FUTURE DIRECTIONS - p. 1747 983. Chapter 101 Abdominal Compartment Syndrome - p. 1750 984. INTRODUCTION - p. 1750 985. DEFINITIONS - p. 1750 986. CONTINUUM OF DISEASE SEVERITY - p. 1750 987. ETIOLOGY/RISK FACTORS - p. 1751 988. PATHOPHYSIOLOGY - p. 1751 989. CLINICAL MANIFESTATIONS - p. 1751 990. DIAGNOSIS - p. 1751 991. MANAGEMENT - p. 1752 992. FUTURE DIRECTIONS - p. 1755 993. CONCLUSIONS - p. 1755 994. Chapter 102 The Acute Abdomen - p. 1757 995. INTRODUCTION - p. 1757 996. CLASSIFICATION - p. 1757 997. INITIAL MANAGEMENT OF THE CHILD WITH AN ACUTE ABDOMEN - p. 1757 998. CRITICAL ABDOMINAL PATHOLOGY - p. 1759 999. ACUTE ABDOMINAL MANIFESTATION OF SYSTEMIC DISEASES - p. 1770 1000. FUTURE DIRECTIONS - p. 1771 1001. Chapter 103 Diagnostic Imaging of the Abdomen - p. 1773 1002. INTRODUCTION - p. 1773 1003. PLAIN RADIOGRAPHS - p. 1773 1004. CONTRAST STUDIES - p. 1777 1005. ULTRASOUND - p. 1779 1006. COMPUTED TOMOGRAPHY - p. 1779 1007. MAGNETIC RESONANCE IMAGING - p. 1779 1008. DIFFERENTIAL DIAGNOSIS AND IMAGING OF ABDOMINAL PATHOLOGY - p. 1779 1009. SUMMARY - p. 1798 1010. FUTURE DIRECTIONS - p. 1798 1011. Chapter 104 Acute Liver Failure and Liver Transplantation - p. 1800 1012. ACUTE LIVER FAILURE - p. 1800 1013. LIVER TRANSPLANTATION - p. 1812 1014. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1819 1015. Chapter 105 Pediatric Intestinal and Multivisceral Transplantation - p. 1823 1016. INTRODUCTION - p. 1823 1017. INDICATIONS - p. 1823 1018. CLINICAL MANAGEMENT OF THE PRETRANSPLANT CHILD IN THE PEDIATRIC INTENSIVE CARE UNIT - p. 1824 1019. THE TRANSPLANT OPERATION - p. 1828 1020. POSTTRANSPLANT MANAGEMENT - p. 1830 1021. OUTCOMES - p. 1834 1022. FUTURE DIRECTIONS - p. 1834 1023. SUMMARY - p. 1835 1024. Section VIII ■ Renal, Endocrine, and Metabolic Disorders - p. 1838 1025. Chapter 106 Adrenal Dysfunction - p. 1838 1026. INTRODUCTION - p. 1838 1027. 1 BIOLOGY OF ADRENAL FUNCTION - p. 1838 1028. 2 ADRENOCORTICAL INSUFFICIENCY - p. 1842 1029. RELATIVE ADRENAL INSUFFICIENCY (CRITICAL ILLNESS–RELATED CORTICOSTEROID INSUFFICIENCY) 3 - p. 1846 1030. 4 ADRENOPAUSE - p. 1848 1031. 5 ADRENAL HYPERFUNCTION - p. 1848 1032. 6 STEROID SUPPLEMENTATION DURING STRESS OR IN THE PERIOPERATIVE PERIOD - p. 1849 1033. THERAPEUTIC GUIDELINES/STEROID PREPARATIONS 7 - p. 1849 1034. OUTCOME - p. 1850 1035. Chapter 107 Disorders of Glucose Homeostasis - p. 1853 1036. DIABETIC KETOACIDOSIS IN CHILDREN - p. 1853 1037. HYPERGLYCEMIC HYPEROSMOLAR SYNDROME - p. 1857 1038. HYPERGLYCEMIA IN CRITICALLY ILL CHILDREN - p. 1858 1039. HYPOGLYCEMIA IN CHILDREN - p. 1861 1040. Chapter 108 Disorders of Water, Sodium, and Potassium Homeostasis - p. 1868 1041. INTRODUCTION - p. 1868 1042. Normal Physiology and Pathophysiology 2 - p. 1868 1043. CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS - p. 1876 1044. 4 Management of Sodium and Potassium Disorders - p. 1883 1045. OUTCOMES: MORBIDITY AND MORTALITY - p. 1887 1046. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1888 1047. Chapter 109 Disorders of Calcium, Magnesium, and Phosphate - p. 1892 1048. DISTRIBUTION OF CALCIUM, MAGNESIUM, AND PHOSPHATE - p. 1892 1049. REGULATION OF CALCIUM, MAGNESIUM, AND PHOSPHATE - p. 1892 1050. DISORDERS OF CALCIUM, MAGNESIUM, AND PHOSPHATE HOMEOSTASIS - p. 1894 1051. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1904 1052. Chapter 110 Thyroid Disease - p. 1906 1053. INTRODUCTION - p. 1906 1054. 1 NORMAL PHYSIOLOGY - p. 1906 1055. Critical Nonthyroidal Illness 2 - p. 1907 1056. HYPOTHYROIDISM - p. 1908 1057. HYPERTHYROIDISM (THYROTOXICOSIS) - p. 1910 1058. CRITICAL HYPOTHYROIDISM: “MYXEDEMA COMA” 4 - p. 1912 1059. CRITICAL HYPERTHYROIDISM: “THYROID STORM” - p. 1914 1060. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1915 1061. Chapter 111 Acute Kidney Injury - p. 1918 1062. DEFINITION OF ACUTE KIDNEY INJURY - p. 1918 1063. EPIDEMIOLOGY - p. 1919 1064. ESTIMATION OF GLOMERULAR FILTRATION RATE - p. 1919 1065. Biomarkers and Clinical Risk Prediction Tools of Acute Kidney Injury 5 - p. 1920 1066. EVALUATION OF ACUTE KIDNEY INJURY - p. 1921 1067. INTRINSIC RENAL ACUTE KIDNEY INJURY - p. 1923 1068. PREVENTION AND TREATMENT OF ACUTE KIDNEY INJURY - p. 1926 1069. PROGNOSIS - p. 1929 1070. CONCLUSIONS - p. 1929 1071. FUTURE DIRECTIONS - p. 1929 1072. Chapter 112 Chronic Kidney Disease, Dialysis, and Kidney Transplantation - p. 1933 1073. DEFINITION AND RISK FACTORS FOR DEVELOPING CHRONIC KIDNEY DISEASE - p. 1933 1074. MANIFESTATIONS OF CHRONIC KIDNEY DISEASE - p. 1934 1075. DIALYSIS AS A KIDNEY REPLACEMENT THERAPY 3 - p. 1935 1076. CONTINUOUS RENAL REPLACEMENT THERAPY - p. 1936 1077. 5 KIDNEY TRANSPLANTATION - p. 1938 1078. FUTURE DIRECTIONS - p. 1940 1079. ACKNOWLEDGMENTS - p. 1940 1080. Chapter 113 Hypertensive Crisis - p. 1942 1081. INTRODUCTION AND DEFINITIONS - p. 1942 1082. PATHOPHYSIOLOGY - p. 1943 1083. EPIDEMIOLOGY - p. 1945 1084. CLINICAL PRESENTATION - p. 1945 1085. CLINICAL EVALUATION - p. 1946 1086. TREATMENT - p. 1947 1087. PARENTERAL ANTIHYPERTENSIVE AGENTS - p. 1948 1088. ORAL ANTIHYPERTENSIVE AGENTS - p. 1950 1089. CONCLUSION AND FUTURE DIRECTIONS - p. 1951 1090. Chapter 114 Inborn Errors of Metabolism - p. 1954 1091. GENERAL APPROACH TO INBORN ERRORS - p. 1954 1092. DISORDERS ASSOCIATED WITH LACTIC ACIDOSIS - p. 1959 1093. METABOLIC ACIDOSIS WITHOUT INCREASED LACTATE - p. 1960 1094. HYPOGLYCEMIA - p. 1961 1095. HYPERAMMONEMIA - p. 1963 1096. LIVER FAILURE - p. 1964 1097. NONMETABOLIC CRITICAL ILLNESS IN INBORN ERRORS OF METABOLISM - p. 1965 1098. CONCLUSIONS AND FUTURE DIRECTIONS - p. 1966 1099. Section IX ■ Oncologic and Hematologic Disorders - p. 1968 1100. Chapter 115 Cancer Therapy: Mechanisms and Toxicity - p. 1968 1101. INTRODUCTION - p. 1968 1102. MECHANISM OF ACTION OF CHEMOTHERAPEUTICS - p. 1968 1103. BASICS OF RADIATION THERAPY - p. 1971 1104. BIOLOGICAL THERAPY - p. 1971 1105. TOXICITIES - p. 1974 1106. FUTURE DIRECTIONS - p. 1977 1107. Chapter 116 Oncologic Emergencies and Complications - p. 1980 1108. INTRODUCTION - p. 1980 1109. SHOCK IN THE CHILD WITH CANCER - p. 1980 1110. HEMATOLOGIC EMERGENCIES - p. 1983 1111. ABNORMAL HEMOSTASIS IN CANCER - p. 1986 1112. WATER, ELECTROLYTE, AND METABOLIC EMERGENCIES - p. 1989 1113. NEUROLOGIC EMERGENCIES - p. 1992 1114. RESPIRATORY EMERGENCIES - p. 1995 1115. ABDOMINAL EMERGENCIES - p. 1997 1116. SUMMARY - p. 1998 1117. FUTURE DIRECTIONS - p. 1998 1118. Chapter 117 Hematologic Emergencies - p. 2003 1119. INTRODUCTION - p. 2003 1120. RED BLOOD CELL ABNORMALITIES - p. 2005 1121. WHITE BLOOD CELL ABNORMALITIES (NONMALIGNANT) - p. 2013 1122. PLATELET ABNORMALITIES - p. 2017 1123. CONCLUSIONS AND FUTURE DIRECTIONS - p. 2025 1124. Chapter 118 Critical Illness Following Hematopoietic Cell Transplantation - p. 2027 1125. OVERVIEW OF HEMATOPOIETIC STEM CELL TRANSPLANTATION IN CHILDREN AND ADOLESCENTS - p. 2027 1126. Respiratory failure - p. 2028 1127. CARDIOVASCULAR COMPLICATIONS - p. 2032 1128. ENDOTHELIOPATHIES - p. 2033 1129. TRANSPLANT ASSOCIATED THROMBOTIC MICROANGIOPATHY (TA-TMA) - p. 2034 1130. GRAFT VERSUS HOST DISEASE - p. 2035 1131. RENAL COMPLICATIONS - p. 2036 1132. NEUROLOGIC DYSFUNCTION - p. 2036 1133. CYTOKINE RELEASE SYNDROME (CRS), CAR-T–RELATED ENCEPHALOPATHY SYNDROME (CRES), AND CAR-T–RELATED HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS (HLH) - p. 2037 1134. SUPPORTIVE CARE FOR TRANSPLANT PATIENTS 9 - p. 2038 1135. SUMMARY, OUTCOMES, AND FUTURE DIRECTIONS - p. 2038 1136. Chapter 119 Coagulation Issues in the Pediatric Intensive Care Unit(s) - p. 2043 1137. OVERVIEW OF COAGULATION - p. 2043 1138. LABORATORY EVALUATION OF THE PATIENT WITH AN ACTUAL OR SUSPECTED COAGULATION DISORDER - p. 2048 1139. CONDITIONS ASSOCIATED WITH SERIOUS BLEEDING, A HIGH PROBABILITY OF BLEEDING, OR SERIOUS HEMOSTATIC SEQUELAE - p. 2050 1140. IATROGENIC COAGULOPATHY - p. 2056 1141. ANTICOAGULANT USE AND MANAGEMENT OF OVERDOSE - p. 2056 1142. PLATELET DISORDERS - p. 2060 1143. THROMBOTIC SYNDROMES - p. 2063 1144. SELECTED DISORDERS - p. 2065 1145. CONCLUSIONS AND FUTURE DIRECTIONS - p. 2065 1146. Chapter 120 Sickle Cell Disease - p. 2071 1147. INTRODUCTION - p. 2071 1148. NORMAL HEMOGLOBIN STRUCTURE AND FUNCTION - p. 2071 1149. PATHOPHYSIOLOGY OF SICKLE CELL DISEASE - p. 2072 1150. ACUTE COMPLICATIONS OF SICKLE CELL DISEASE - p. 2076 1151. CHRONIC COMPLICATIONS OF SICKLE CELL DISEASE - p. 2081 1152. PERIOPERATIVE CARE OF PATIENTS WITH SICKLE CELL DISEASE - p. 2084 1153. OUTCOMES - p. 2085 1154. NEW CONCEPTS IN UNDERSTANDING SICKLE CELL DISEASE AND FUTURE DIRECTIONS FOR RESEARCH - p. 2086 1155. ACKNOWLEDGMENTS - p. 2087 1156. Appendix: Common Equations Used in Pediatric Critical Care - p. A-1 1157. Index - p. 2091