The development of pediatric cardiac surgical programs has had a profound effect on the s- cialty of pediatric critical care medicine, and as a result, the ? eld of pediatric cardiac intensive care is rapidly emerging as a separate subspecialty of pediatric critical care medicine. The ability to provide care for the critically ill child with congenital heart disease clearly separates pediatric intensivists from our adult colleagues. A thorough understanding and knowledge of the unique physiology of the child with congenital heart disease are therefore absolutely crucial for anyone working in the pediatric intensive care unit. Once again, we would like to dedicate this textbook to our families and to the physicians and nurses who provide steadfast care every day in pe- atric intensive care units across the globe. Derek S. Wheeler Hector R. Wong Thomas P. Shanley v Preface to Pediatric Critical Care Medicine: Basic Science and Clinical Evidence The ? eld of critical care medicine is growing at a tremendous pace, and tremendous advances in the understanding of critical illness have been realized in the last decade. My family has directly bene? ted from some of the technological and scienti? c advances made in the care of critically ill children. My son Ryan was born during my third year of medical school. By some peculiar happenstance, I was nearing completion of a 4-week rotation in the newborn intensive care unit (NICU).

The principal role of the respiratory system is to permit ef? cient exchange of respiratory gases (O and CO ) with the environment. The respiratory system is unique in that it is constantly 2 2 exposed to a barrage of foreign substances from both the internal environment (at any one point in time, approximately one-half of the cardiac output is received by the lungs) and the external environment (with each breath, the respiratory tract is exposed to pollens, viruses, bacteria, smoke, etc). According to the Centers for Disease Control and Prevention, diseases of the res- ratory system were the seventh and eighth leading causes of deaths in children aged 1 to 19 years in 2003 [1]. Dr. George A. Gregory, one of the founding fathers of pediatric critical care me- cine, once estimated that acute respiratory failure accounts for nearly 50% of all admissions to the pediatric intensive care unit (PICU) [2]. Just as important are the many diseases that affect the respiratory system that are not associated with acute respiratory failure, but nevertheless constitute a major portion of the practice of pediatric critical care medicine, some of which account for signi? cant morbidity and mortality [3]. Once again, we would like to dedicate this textbook to our families and to the physicians and nurses who provide steadfast care every day in pediatric intensive care units across the globe. Derek S. Wheeler Hector R. Wong Thomas P.

Neurologic emergencies are a common reason for admission to the pediatric intensive care unit (PICU). A thorough understanding of the diseases and disorders affecting the pediatric central nervous system is vital for any physician or healthcare provider working in the PICU. In the following pages, an international panel of experts provides an in-depth discussion on the res- citation, stabilization, and ongoing care of the critically ill or injured child with central nervous system dysfunction. Once again, we would like to dedicate this textbook to our families and to the physicians and nurses who provide steadfast care every day in pediatric intensive care units across the globe. Derek S. Wheeler Hector R. Wong Thomas P. Shanley v Preface to Pediatric Critical Care Medicine: Basic Science and Clinical Evidence The ? eld of critical care medicine is growing at a tremendous pace, and tremendous advances in the understanding of critical illness have been realized in the last decade. My family has directly bene? ted from some of the technological and scienti? c advances made in the care of critically ill children. My son Ryan was born during my third year of medical school. By some peculiar happenstance, I was nearing completion of a 4-week rotation in the newborn intensive care unit (NICU).

In the highly specialized field of caring for children in the PICU, Fuhrman and Zimmerman's Pediatric Critical Care is the definitive reference for all members of the pediatric intensive care team. Drs. Jerry J. Zimmerman and Alexandre T. Rotta, along with an expert team of editors and contributors from around the world, have carefully updated the 6th Edition of this highly regarded text to bring you the most authoritative and useful information on today's pediatric critical care—everything from basic science to clinical applications. - Contains highly readable, concise chapters with hundreds of useful photos, diagrams, algorithms, and clinical pearls. - Uses a clear, logical, organ-system approach that allows you to focus on the development, function, and treatment of a wide range of disease entities. - Features more international authors and expanded coverage of global topics including pandemics, sepsis treatment in underserved communities, specific global health concerns by region. - Covers current trends in sepsis-related mortality and acute care after sepsis, as well as new device applications for pediatric patients. - Provides ultrasound videos and more than 500 board-style review questions and answers on Expert Consult. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

The topics in this issue represent the most current research areas of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Collaborative Pediatric Critical Care Research Network (CPCCRN). The CPCCRN is a national pediatric critical care research network that is charged with investigating the efficacy of treatment and management strategies to care for critically ill and injured children, as well as to better understand the pathophysiological basis of critical illness and injury in childhood. The proposed authors are past and present principal and co-investigators affiliated with the CPCCRN; the proposed topics represent the individual author’s area of clinical and research expertise. Each review article is an up-to-date review of the topic relevant to practicing clinicians and trainees in critical care medicine, with incorporation of the most recently published research findings pertinent to the topic, some of which may be the author’s own. The specific articles are devoted to the following topics: Cardiopulmonary resuscitation in pediatric and cardiac ICU; Approach to the critically ill pediatric trauma patient; Transfusion Decision Making in Pediatric Critical Illness; Pathophysiology and management of ARDS in children; Ventilator associate pneumonias in critically ill children; Mechanical ventilation and decision support in pediatric intensive care; Inflammation, pathobiology, phenotypes and sepsis: From meningococcemia to H1N1-MRSA, to Ebola; Immune paralysis in pediatric critical care; Molecular biology of critical illness; Sedation in pediatric critical illness; Delirium in pediatric critical illness; Challenges of drug development in pediatric intensive care; Potential of All Steroid Hormone Subclasses as Adjunctive Treatment for Sepsis; Morbidity: Changing the outcome paradigm; and End-of-Life and Bereavement Care in Pediatric Intensive Care Units.

The second edition of Pediatric Critical Care Medicine spans three volumes, with major sections dedicated to specific organ systems. Each major section consists of separate chapters dedicated to reviewing the specific disease processes affecting each organ system. Each chapter concludes with a comprehensive list of references, with brief, concise remarks denoting references of ‘special interest’ and ‘of interest’. Consequently, the books are unique in their comprehensive coverage of pediatric critical care and their ease of use and will be of value to those studying towards pediatric critical care examinations and those who are already qualified.

Still the #1 resource for today’s pediatric ICU teams, Pediatric Critical Care, 5th Edition covers the entire field, from basic science to cutting-edge clinical applications. Drs. Bradley P. Fuhrman and Jerry J. Zimmerman, accompanied by an expert team of editors and contributors from around the world, bring you today’s best information on the current and future landscape of pediatric critical care so you can consistently deliver optimum care to your young patients. Boasts highly readable, concise chapters with hundreds of useful photos, diagrams, algorithms, and clinical pearls. Clear, logical, organ-system approach allows you to focus on the development, function, and treatment of a wide range of disease entities. Includes new content on the expanding use of ultrasound at the bedside and the increase in nursing responsibilities in the PICU. Eighteen new chapters cover topics such as delirium, metabolism, endocrinology, nutrition, nursing, and much more. Features expanded and updated information on critical communication, professionalism, long-term outcomes, palliative care, ultrasonography, PCCM in resource-limited settings, ventilator-induced lung injury, non-invasive ventilation, updated CNS pathophysiology, the ‘Erythron’, and immunity and infection.

This volume provides an overview of the most important current controversies in the field of pediatric intensive care. Organized into sections based on organ systems, the text focuses on controversies surrounding disease processes of the cardiac, respiratory, gastrointestinal, hematologic / immunologic, endocrine, and neurologic systems. Each chapter reviews the pros and cons of specific management approaches through case studies and the most up-to-date evidence-based resources, and concludes with bulleted take-home points for ease of use. Written by experts in the field, Pediatric Critical Care: Current Controversies is a valuable resource for intensivists, advanced practice providers, nurses, and other health care providers involved in the care of critically-ill children.

Demand for neuromonitoring in neonatal, pediatric and cardiac intensive care units continues to grow, motivated by increased awareness of the high prevalence of seizures among critically ill neonates and children, and emerging evidence that these seizures can contribute to brain injury. This book provides physicians, nurses and trainees caring for critically ill newborns and children with a practical overview of how to use and interpret continuous neuromonitoring to enhance patient care. Authored by international experts from diverse institutions and professional backgrounds, this is a practical guide that is accessible to intensive care specialists, but also comprehensive enough to serve as a reference book for neurologists and neurophysiologists. Concise enough to be read cover-to-cover and illustrated with over thirty case-based examples, this authoritative reference will guide readers in accurate neuromonitoring interpretation and optimal use of conventional EEG, amplitude-integrated EEG and other quantitative EEG techniques.