Transfusion medicine
• The decision to prescribe the transfusion of any blood product must be based on individualized indications and must take into account specific health problems. • Acute severe anemia (hemoglobin…
Thrombosis in pediatric critical care
• Vascular access devices are the most common cause of thromboembolic disease in children; thus, every attempt should be made to limit their use based on real clinical need. •…
The erythron
Pearls • Together, red blood cells (RBCs) at each stage of development may be considered an organ (termed the erythron ) now appreciated to participate in active regulation of regional…
Structure and function of the hematopoietic organs
• Normal ranges for blood cell numbers are dependent on age, gender, and race. • Because the bone marrow circulation connects with the general circulation, fluids and medications injected into…
Diabetic ketoacidosis
• Diabetic ketoacidosis (DKA) results either from absolute insulin deficiency or from relative insulin deficiency in the setting of high levels of counterregulatory hormones stimulated by infection or other illness….
Endocrine emergencies
Pearls • Cortisol is a key mediator of the stress response—influencing immunity, metabolism, and modulating the transcription of perhaps 25% of the entire genome. • Relative adrenal insufficiency and critical…
Molecular foundations of cellular injury
• Cell death is an important physiologic homeostatic mechanism critical for host survival. • Regulated cell death pathways are evolutionarily conserved processes and include caspase-dependent (apoptosis, pyroptosis) and caspase-independent (necroptosis,…
Progress towards precision medicine in critical illness
Pearls • The goal of precision medicine in the context of critical care is for treatment strategies to be developed that take into account the variability seen between individuals. •…
Inborn errors of metabolism
• Unexpected and unexplained clinical deterioration in a previously healthy infant or child is an important clue to the presence of an inborn error of metabolism (IEM). • Loss of…
Biology of the stress response
Pearls • The stress response is a universal, stereotypical, and integrated neurogenic, endocrine, inflammatory, and metabolic systems response with multiple feed-forward and feed-backward modulation signaling designed to maximize host survival….
