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The development of pediatric cardiac surgical programs has had a
profound effect on the s- cialty of pediatric critical care
medicine, and as a result, the ? eld of pediatric cardiac intensive
care is rapidly emerging as a separate subspecialty of pediatric
critical care medicine. The ability to provide care for the
critically ill child with congenital heart disease clearly
separates pediatric intensivists from our adult colleagues. A
thorough understanding and knowledge of the unique physiology of
the child with congenital heart disease are therefore absolutely
crucial for anyone working in the pediatric intensive care unit.
Once again, we would like to dedicate this textbook to our families
and to the physicians and nurses who provide steadfast care every
day in pe- atric intensive care units across the globe. Derek S.
Wheeler Hector R. Wong Thomas P. Shanley v Preface to Pediatric
Critical Care Medicine: Basic Science and Clinical Evidence The ?
eld of critical care medicine is growing at a tremendous pace, and
tremendous advances in the understanding of critical illness have
been realized in the last decade. My family has directly bene? ted
from some of the technological and scienti? c advances made in the
care of critically ill children. My son Ryan was born during my
third year of medical school. By some peculiar happenstance, I was
nearing completion of a 4-week rotation in the newborn intensive
care unit (NICU).
The principal role of the respiratory system is to permit ef? cient
exchange of respiratory gases (O and CO ) with the environment. The
respiratory system is unique in that it is constantly 2 2 exposed
to a barrage of foreign substances from both the internal
environment (at any one point in time, approximately one-half of
the cardiac output is received by the lungs) and the external
environment (with each breath, the respiratory tract is exposed to
pollens, viruses, bacteria, smoke, etc). According to the Centers
for Disease Control and Prevention, diseases of the res- ratory
system were the seventh and eighth leading causes of deaths in
children aged 1 to 19 years in 2003 [1]. Dr. George A. Gregory, one
of the founding fathers of pediatric critical care me- cine, once
estimated that acute respiratory failure accounts for nearly 50% of
all admissions to the pediatric intensive care unit (PICU) [2].
Just as important are the many diseases that affect the respiratory
system that are not associated with acute respiratory failure, but
nevertheless constitute a major portion of the practice of
pediatric critical care medicine, some of which account for signi?
cant morbidity and mortality [3]. Once again, we would like to
dedicate this textbook to our families and to the physicians and
nurses who provide steadfast care every day in pediatric intensive
care units across the globe. Derek S. Wheeler Hector R. Wong Thomas
P.
The care of the critically ill or injured child begins with timely,
prompt, and aggressive res- citation and stabilization. Ideally,
stabilization should occur before the onset of organ failure in
order to achieve the best possible outcomes. In the following
pages, an international panel of experts provides an in-depth
discussion of the early recognition, resuscitation, and
stabilization of the critically ill or injured child. Once again,
we would like to dedicate this textbook to our families and to the
physicians and nurses who provide steadfast care every day in
pediatric intensive care units across the globe. Derek S. Wheeler
Hector R. Wong Thomas P. Shanley V Preface to Pediatric Critical
Care Medicine: Basic Science and Clinical Evidence The ? eld of
critical care medicine is growing at a tremendous pace, and
tremendous advances in the understanding of critical illness have
been realized in the last decade. My family has directly bene? ted
from some of the technological and scienti? c advances made in the
care of critically ill children. My son Ryan was born during my
third year of medical school. By some peculiar happenstance, I was
nearing completion of a 4-week rotation in the newborn intensive
care unit (NICU). The head of the pediatrics clerkship was kind
enough to let me have a few days off around the time of the
delivery-my wife, Cathy, was 2 weeks past her due date and had been
scheduled for elective induction.
The ? eld of critical care medicine is in the midst of a dramatic
change. Technological and s- enti? c advances during the last
decade have resulted in a fundamental change in the way we view
disease processes, such as sepsis, shock, acute lung injury, and
traumatic brain injury. Pediatric intensivists have been both
witness to and active participants in bringing about these changes.
As the understanding of the pathogenesis of these diseases reaches
the cellular and molecular levels, the gap between critical care
medicine and molecular biology will disappear. It is imperative
that all physicians caring for critically ill children in this new
era have a th- ough understanding of the applicability of molecular
biology to the care of these patients at the bedside in order to
keep up with the rapidly evolving ? eld of critical care medicine.
To the same extent, the practice of critical care medicine is in
the midst of fundamental change. In keeping with the Institute of
Medicine's report "Crossing the Quality Chasm," the care of
critically ill and injured children needs to be safe,
evidence-based, equitable, ef? cient, timely, and fami- centered
[1,2]. In the following pages, these changes in our specialty are
discussed in greater scope and detail, offering the reader fresh
insight into not only where we came from, but also where we are
going as a specialty.
This second edition spans four volumes, with major sections
dedicated to specific organ systems. Each major section consists of
separate chapters dedicated to reviewing the specific disease
processes affecting each organ system. Each chapter concludes with
a comprehensive list of references, with brief, concise remarks
denoting references of 'special interest' and 'of interest'.
Consequently, the books are unique in their comprehensive coverage
of pediatric critical care and their ease of use and will be of
value to those studying towards pediatric critical care
examinations and those who are already qualified.
The second edition of Pediatric Critical Care Medicine spans four
volumes, with major sections dedicated to specific organ systems.
Each major section consists of separate chapters dedicated to
reviewing the specific disease processes affecting each organ
system. Each chapter concludes with a comprehensive list of
references, with brief, concise remarks denoting references of
'special interest' and 'of interest'. Consequently, the books are
unique in their comprehensive coverage of pediatric critical care
and their ease of use and will be of value to those studying
towards pediatric critical care examinations and those who are
already qualified.
Neurologic emergencies are a common reason for admission to the
pediatric intensive care unit (PICU). A thorough understanding of
the diseases and disorders affecting the pediatric central nervous
system is vital for any physician or healthcare provider working in
the PICU. In the following pages, an international panel of experts
provides an in-depth discussion on the res- citation,
stabilization, and ongoing care of the critically ill or injured
child with central nervous system dysfunction. Once again, we would
like to dedicate this textbook to our families and to the
physicians and nurses who provide steadfast care every day in
pediatric intensive care units across the globe. Derek S. Wheeler
Hector R. Wong Thomas P. Shanley v Preface to Pediatric Critical
Care Medicine: Basic Science and Clinical Evidence The ? eld of
critical care medicine is growing at a tremendous pace, and
tremendous advances in the understanding of critical illness have
been realized in the last decade. My family has directly bene? ted
from some of the technological and scienti? c advances made in the
care of critically ill children. My son Ryan was born during my
third year of medical school. By some peculiar happenstance, I was
nearing completion of a 4-week rotation in the newborn intensive
care unit (NICU).
The second edition of Pediatric Critical Care Medicine spans
three volumes, with major sections dedicated to specific organ
systems.Each major section consists of separate chapters dedicated
to reviewing the specific disease processes affecting each organ
system.Each chapter concludes with a comprehensive list of
references, with brief, concise remarks denoting references of
special interest and of interest .Consequently, the books are
unique in their comprehensive coverage of pediatric critical care
and their ease of use and will be of value to those studying
towards pediatric critical care examinations and those who are
already qualified."
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