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),…
Hyperthermic injury
• According to the Centers for Disease Control and Prevention, from 1999 to 2010, 7415 deaths were attributable to excessive heat exposure or hyperthermia in the United States. • With…
Healthcare-associated infections
• Hand hygiene is foundational to infection control in the pediatric intensive care unit (PICU), including the prevention of healthcare-associated infections (HAIs); units should be relentless in pursuing compliance with…
Pediatric rheumatologic disease
• Approximately 1 child in 250 has a rheumatologic disease. • A child may present to the intensive care unit (ICU) with a life-threatening manifestation of an undiagnosed rheumatologic disease…
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…
Life-threatening viral diseases and their treatment
• Clinicians should obtain serum to store for future serologic testing when viral pathogens are considered as the potential cause of a critical illness. • Multiplex polymerase chain reaction panels…
Bacterial and fungal infections
• Emergence of resistant organisms is increasing in critically ill patients, requiring clinicians to use alternative drug and dosing strategies and to become familiar with institutional-specific resistance profiles. • Infectious…
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…
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…
