Pediatric Critical Care: Text and Study Guide

1602 Pages·2021·41.014 MB·English

by  Steven E. Lucking, Frank A. Maffei, Robert F. Tamburro, Arno Zaritsky

Steven E. Lucking
Frank A. Maffei
Robert F. Tamburro
Arno Zaritsky
Editors
PE D IATR IC
CRITICAL CARE
TEXT AND STUDY GUIDE
Second Edition
123
Pediatric Critical Care
Steven E. Lucking • Frank A. Maffei
Robert F. Tamburro • Arno Zaritsky
Editors
Pediatric Critical
Care
Text and Study Guide
Second Edition
Editors
Steven E. Lucking Frank A. Maffei
Penn State Hershey Children’s Hospital Division of Pediatric Critical Care,
Pediatric Critical Care Medicine Department of Pediatrics
Hershey, PA Janet Weis Children’s Hospital,
USA Geisinger Medical Center
Danville, PA
Robert F. Tamburro USA
Department of Pediatrics/Divisions of
Pediatric Critical and Palliative Care Geisinger Commonwealth School of
Medicine Medicine
Janet Weis Children’s Hospital at Scranton, PA
Geisinger, Geisinger Commonwealth USA
School of Medicine
Danville, Pennsylvania Arno Zaritsky
USA Department of Pediatrics
Eastern Virginia Medical School,
Children’s Hospital of The King’s
Daughters
Norfolk, Virginia
USA
ISBN 978-3-030-53362-5 ISBN 978-3-030-53363-2 (eBook)
https://doi.org/10.1007/978-3-030-53363-2
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V
Preface
The multidisciplinary nature of pediatric critical care medicine creates a con-
siderable challenge to those who seek to master the discipline. The knowledge
that the critical care pediatrician must possess encompasses aspects of many
different organ-based specialties. Our goal for this text is to help young critical
care physicians review and master fundamental principles of our specialty for
the purpose of achieving certification. In addition, we hope that the text will be
a practical resource for the practice of pediatric critical care incorporating con-
cepts of pathophysiology, therapeutic theory, and management principals.
We are indebted to our authors for their willingness to share their consider-
able expertise and contribute to this labor. We are grateful for their efforts and
their patience as we navigated the pitfalls in getting the work completed.
We hope that the text will help the practitioner achieve success in the prac-
tice of pediatric critical care medicine. The care of children is both a privilege
and a blessing. To care for children at their most vulnerable time cannot help
but provide the practitioner with awe for the beauty of life and the resilience of
the child’s spirit, a respect for the power of a parent’s love, and an appreciation
of the blessing of our own children’s health.
Steven E. Lucking, MD
Hershey, PA, USA
Acknowledgments
When we first began this endeavor years ago, we were told by many experi-
enced colleagues that putting together a quality textbook is a labor of love, a
greater truth has not been told. However, when we were told a second edition
would be so much easier than the first, that turned out to be not so true.
The work has been difficult at times, but always rewarding and worthwhile.
As editors, we are proud of the textbook, but clearly recognize that the project
would never have come to fruition without key individuals who have supported
us through this arduous process.
To our wives: Lynn, Tricia, Janet, and Peggy, who supported and guided us
throughout the entire project. Without their love, wisdom, and tireless sup-
port, this book would have never reached completion.
To our children, who serve as the inspiration and guiding force for each
of us.
To the authors of every chapter. Without their intellect, hard work, and
drive to teach, the dissemination of this important knowledge to the next gen-
eration of pediatric intensivists would not be possible. We particularly want to
thank our authors for their efforts during the late stages of the publication
when many of them assumed increased clinical and administrate duties in
response to the COVID-19 pandemic. On that note, the editors decided not to
include a separate section on the SARS CoV-2 virus and the pandemic as the
data was still in evolution and publication of an evidence based chapter would
have been premature.
Two additional special acknowledgements:
We want to thank and acknowledge our Co-editor, Dr. Steven Lucking.
After 35 years of service as a Pediatric Intensivist, Steve will be turning his
attention to travel, baseball, and serving as a pediatrician on medical missions.
Steve has been a foundational and transformative leader in the field of pediat-
ric critical care. He has been the quintessential bedside intensivist—shepherd-
ing our sickest children through the rigors of critical illness. He has served as a
mentor to many—always placing the academic achievements of his colleagues
above his own. Always an advocate, critical thinker, and most importantly a
selfless friend.
Lastly, my wife Lynn Maffei, who during the writing of the second edition,
developed a health crisis. She has been the model of courage, perseverance, and
faithfulness. Our love can and will overcome all.
»
God watches over small children and fools…he has us all covered.
Frank A. Maffei, MD
Robert F. Tamburro, MD, MSc
Arno L. Zaritsky, MD
Steven E. Lucking, MD
VII
Contents
Volume I
I Essential Physiologic Principles
1 Genomics and Genetic Predisposition to Critical Illness in the
Pediatric Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Mary K. Dahmer and Michael W. Quasney
2 Oxygen Delivery and Oxygen Consumption in Pediatric
Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Juan A. Gutierrez and Andreas A. Theodorou
3 Endothelial Interactions and Coagulation . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Trung C. Nguyen and Joseph A. Carcillo
4 The Inflammatory Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Mark W. Hall
5 Nutrition in Critical Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Margaret A. Satchell
6 P harmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Robert P. Kavanagh, Lindsay C. Trout, and Gretchen L. Brummel
II Respiratory
7 Pulmonary Structure and Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Jonathan Spahr
8 Fundamentals of Gas Exchange and the Assessment
of Oxygenation and Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
John S. Sullivan and Toah Nkromah Alafita
9 Upper Airway Obstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Steven E. Lucking
10 S evere Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Ronald Wong and Frank A. Maffei
11 Pediatric Acute Respiratory Distress Syndrome . . . . . . . . . . . . . . . . . . . . . 251
Garrett Keim and Nadir Yehya
VIII Contents
12 C onventional Mechanical Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Guillaume Emeriaud, Christopher Newth, Robinder Khemani,
and Philippe Jouvet
13 N onconventional Mechanical Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Michael D. Dettorre
III Cardiovascular
14 H emodynamics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
Scott A. Hagen, Awni M. Al-Subu, Nathan Thompson,
and Timothy E. Corden
15 R egional Circulations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
Arno L. Zaritsky, Demetri Yannopoulos, and Vinay M. Nadkarni
16 Assessment of Cardiovascular Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413
Frank A. Maffei
17 C irculatory Failure/Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469
Stephen Pfeiffer and Hector R. Wong
18 Disorders of Cardiac Rhythm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493
C. James Smith and William G. Harmon
19 Postoperative Cardiac Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 523
Orkun Baloglu, William Hanna, and Mohammed Hamzah
20 C ardiovascular Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 559
Frank A. Maffei, Jennifer E. L. Diep, and Arno L. Zaritsky
21 Mechanical and Electrical Myocardial Support . . . . . . . . . . . . . . . . . . . . . . 607
Adrian D. Zurca, Duane C. Williams, Jason R. Imundo,
and Gary D. Ceneviva
IV Central and Peripheral Nervous System
22 Central and Peripheral Nervous Systems: Development,
Structure, and Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639
Daniel J. Rogers, Kiran M. Sargar, and Frank A. Maffei
23 Physiology of Skeletal Muscle and the Neuromuscular
Junction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 677
Michael T. Davis and Michael P. Eaton
24 Assessment of Neurologic Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 689
Elizabeth E. Scarlett and Jill M. Gotoff
IX
Contents
25 Cerebral Resuscitation and Traumatic and Hypoxic- Ischemic
Brain Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 729
Ericka L. Fink, Alicia K. Au, Dennis Simon, Patrick M. Kochanek,
and Robert S. B. Clark
26 Neurological Diseases in Pediatric Critical Care . . . . . . . . . . . . . . . . . . . . . 767
Anne Marie Morse, Michael J. Bell, and Frank A. Maffei
27 Sedation and Analgesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 797
Richard L. Lambert and Frank A. Maffei
28 N euromuscular Blockade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831
Michael T. Davis and Michael P. Eaton
V Renal and Electrolyte
29 Overview, Structure, and Function of the Nephron . . . . . . . . . . . . . . . . . 863
George J. Schwartz and Megan Rashid
30 F luid/Electrolyte/Acid-Base Abnormalities . . . . . . . . . . . . . . . . . . . . . . . . . . 911
Michael L. Moritz
31 Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 955
William S. Varade and Elif Erkan
32 R enal Replacement Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 983
Timothy E. Bunchman
Volume II
VI Infectious Disease
33 Acute Pulmonary Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1003
Karen S. Powers and Erin E. Barker
34 S epsis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1035
Erin Carlton, Angela Lorts, Thomas P. Shanley, and Timothy T. Cornell
35 Overwhelming Infections in Pediatric Critical Care . . . . . . . . . . . . . . . . . . 1059
Swathi Gowtham, Raghuveer Puttagunta, and Jennifer Vodzak
36 Multiple Organ Dysfunction Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1085
Nikoleta S. Kolovos
37 H ealthcare-Associated Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1105
Elise W. van der Jagt and S. Rhodes Proctor Short
X Contents
VII Hematology
38 Disseminated Intravascular Coagulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1147
Robert F. Tamburro, Ahmad Al-Huniti, Mariella Vargas-Gutierrez,
Jorge Gonzalez Ulloa, and Leonardo R. Brandão
39 Oncological Critical Care Considerations in Children . . . . . . . . . . . . . . . 1167
Arun Saini and Swati Karmarkar
40 Care of the Critically Ill Pediatric Hematopoietic Cell
Transplant Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1207
Sajad Jawad Khazal, Dristhi Ragoonanan, Janet Hume,
Courtney Marie Rowan, and Kris Michael Mahadeo
41 T ransfusion Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1243
Suzie A. Noronha and Jill M. Cholette
VIII Gastrointestinal
42 Acute Liver Injury and Failure in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1289
Richard L. Lambert
IX Endocrine and Metabolic
43 Critical Care Endocrinology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1317
Kecha A. LynShue, Mabel Yau, and Mark A. Sperling
44 M etabolic Crises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1351
Kevin A. Strauss
X Special Topics and Populations
45 T rauma/Burn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1399
Brett W. Engbrecht and Robert E. Cilley
46 Toxicology for the Pediatric Intensivist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1425
Steven J. Crellin and L. Eugene Daugherty
47 The Approach to the Critically Ill Infant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1461
Frank A. Maffei and Tessy A. Thomas
48 C hild Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1491
Caroline L. S. George