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…
CRITICAL CARE
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…
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…
