Acid-base disorders
Pearls • Abnormalities in acid-base balance should be anticipated in all critically ill children due to their underlying disease or intensive care unit therapy and should be monitored closely. •…
Neuroimaging
Pearls • Multiple imaging modalities are available for evaluation of the brain, head, neck, and spine of the critically ill child. The most appropriate modality depends on consideration of patient…
Fluid and electrolyte issues in pediatric critical illness
Pearls • Hypotonic maintenance intravenous (IV) fluids are associated with mild to moderate hyponatremia in postoperative patients. Anesthesia, stress, and inflammatory mediators may contribute. Electrolyte monitoring in patients at risk…
Hypoxic-ischemic encephalopathy
Pearls • Cardiac arrest in pediatric patients is predominantly due to asphyxia. This is in contrast to adults, for whom, despite an increase in asphyxial cardiac arrest related to the…
Central nervous system infections and related conditions
Pearls • The classic triad of fever, neck stiffness, and a change in mental status is present in less than 50% of pediatric meningitis cases. • Streptococcus species (particularly viridans…
Acute rehabilitation and early mobility in the pediatric intensive care unit
Pearls • Increased survival from pediatric critical illness has been accompanied by an increase in both short- and long-term morbidities for children undergoing active neurocognitive development. • The harms of…
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…
Critical care considerations for common neurosurgical conditions
Pearls • Hydrocephalus is a common brain disease characterized by a buildup of cerebrospinal fluid within the brain, causing elevated intracranial pressure. Untreated hydrocephalus can be a medical emergency, requiring…
Intracranial hypertension and monitoring
Pearls • As intracranial hypertension progresses, changes may occur in the vital signs, with an elevation of blood pressure, decrease or increase in pulse, and irregularity in the respiratory rhythm….
Acute neuromuscular disease and disorders
Pearls • Common causes of acute flaccid paralysis in childhood include Guillain-Barré syndrome (GBS), acute flaccid myelitis, botulism, tick paralysis, periodic paralyses, and organophosphate poisoning. • Risk factors for respiratory…
