Overview of breathing failure
Pearls • Three pathways to breathing failure are impaired neural control, failure of the muscles of breathing, and dysfunction of the mechanics of breathing. • Dysfunction of the mechanics of…
Structure and development of the upper respiratory system
Pearls • The structures of the upper airway undergo extensive changes from infancy through young adulthood. An understanding of the numerous variations, congenital anomalies, and resulting special vulnerabilities of the…
Physiologic foundations of cardiopulmonary resuscitation
Pearls • Both the cardiac and thoracic pump mechanisms play a role in infants and children during cardiopulmonary resuscitation. Thus, attention to excellent chest compression technique—with an emphasis on “push…
Performance of cardiopulmonary resuscitation in infants and children
Pearls • There are four distinct phases of cardiac arrest and cardiopulmonary resuscitation (CPR): prearrest, no-flow (untreated cardiac arrest), low-flow (CPR), and postarrest. • The most common precipitating event for…
Pediatric cardiopulmonary bypass
Pearls • Cardiopulmonary bypass (CPB), which originated in the mid-twentieth century, was designed to allow for the repair of congenital heart defects. Its history has since been characterized by perpetual…
Cardiac transplantation
Pearls • Most pediatric transplantations are performed for cardiomyopathy or congenital heart disease not amenable to correction or palliation. • Individuals may have a good quality of life following heart…
Critical care after surgery for congenital cardiac disease
Pearls • The neonatal myocardium is less compliant than that of the older child, less tolerant of increases in afterload, and less responsive to increases in preload. A predictable decrease…
Shock states
The clinical syndrome of shock is one of the most dramatic, dynamic, and life-threatening problems faced by the physician in the critical care setting. Although untreated shock is universally lethal,…
Disorders of cardiac rhythm
Pearls • Arrhythmias may result from ongoing therapies; ask, “What’s the DEAL?” ( d rugs and drips, e lectrolytes, a irway and acid-base, l ines). • Appropriate diagnosis is key….
Cardiopulmonary interactions
Pearls • Positive-pressure ventilation (PPV) alters ventricular loading conditions and compliance. • In patients who are hypovolemic, the effects of positive airway pressure on the right heart predominate, whereas in…
