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…
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…
Adaptive immunity
• Unlike the innate immune response, the adaptive immune response is characterized by specific antigen recognition and immunologic memory. • Lymphocytes are the key cell types of the adaptive immune…
Critical illness and the microbiome
• Like all organisms, humans have evolved in concert with microbes that serve numerous physiologic and immune functions during normal development and homeostasis. • Critical illness in both children and…
Nutrition of the critically ill child
• Provision of individually tailored optimal nutrition is an important goal of pediatric critical care. • Malnutrition is prevalent in the pediatric intensive care unit (PICU) and is associated with…
Acute abdomen
• The abdomen is both a primary source of disease conditions that require care in the intensive care unit (ICU) and, frequently, a secondary source of additional pathophysiology for children…
Hepatic transplantation
Pearls • Liver transplantation (LT) has become the standard of care for children with end-stage or metabolic liver disease, acute liver failure, and unresectable liver tumors, with most common indication…
Acute liver failure
• Pediatric acute liver failure represents a large number of heterogenous etiologies. • Effective diagnosis requires a systemic approach; however, despite thorough workup, in a large proportion of cases, cause…
