COVER -- HALF-TITLE -- DEDICATION -- TITLE -- COPYRIGHT -- CONTENTS -- PREFACE -- Section 1 Basic Principles of PICU -- CHAPTER 1 DIFFERENCES BETWEEN THE CHILD, THE NEONATE AND THE ADULT -- Anatomy and physiology -- Airway -- Problems/relevance -- Breathing -- Problems/relevance -- Cardiovascular -- Problems/relevance -- CNS -- Problems/relevance -- Neuro-muscular junction -- Renal -- Temperature control -- Problems/relevance -- Blood -- Pharmacology -- Pharmacokinetics -- Absorption -- Distribution -- Protein binding -- Elimination -- Pharmacodynamics -- CHAPTER 2 NEONATAL PROBLEMS IN THE PICU -- Respiration -- Respiratory distress syndrome -- Cardiovascular -- Patent ductus arteriosus -- Persistent foetal circulation -- Environment -- Gastrointestinal -- Necrotising enterocolitis -- CNS -- Intra-ventricular haemorrhage -- Retinopathy of prematurity (retrolentral fibroplasia) -- CHAPTER 3 RESUSCITATION -- Infant -- Small child 8 years -- Advanced life support -- Epinephrine (adrenaline) -- Alkalising agents -- Intra-venous fluids -- Anti-arrhythmic drugs -- CHAPTER 4 THE STRUCTURED APPROACH TO THE SERIOUSLY INJURED CHILD -- Initial assessment - the primary survey -- Airway -- Cervical spine -- Breathing -- Circulation -- Treatment -- Disability -- Exposure -- X-rays -- Detailed assessment - the secondary survey -- Analgesia -- Notes -- CHAPTER 5 AIRWAY AND VENTILATION -- Endotracheal tube requirements -- Confirmation of successful intubation -- Complications of intubation -- Criteria for extubation -- Immediate complications of extubation -- Laryngospasm -- Post-extubation stridor -- Oral endotracheal tubes -- Advantages -- Disadvantages -- Nasal endotracheal tubes -- Advantages -- Disadvantages -- Contra-indications -- Tracheostomy -- Advantages -- Disadvantages -- Ventilation.

Physiological effects of intermittent positive pressure ventilation (IPPV) -- Respiratory -- Cardiovascular -- Positive effects -- Goals of ventilation -- Aims of ventilation -- Ventilation strategy -- Volume controlled ventilation -- Advantages -- Disadvantages -- Pressure controlled ventilation -- Advantages -- Disadvantages -- Other strategies -- High frequency oscillation (HFO) (Table 5.5) -- Complications -- Advantages -- Practical considerations -- High frequency jet ventilation -- Surfactant -- Inhaled nitric oxide (iNO) -- Uses -- Practical problems -- Side effects -- Liquid ventilation -- Extracorporeal membrane oxygenation (ECMO) -- Indications -- Clinical -- Weaning from ventilation -- Background principles -- Weaning criteria -- Methods -- Problems with weaning -- Oxygen -- Effects of ventilation on the lung -- Non-invasive ventilation -- Indications -- Advantages -- Disadvantages -- CHAPTER 6 CIRCULATION AND RHYTHM DISTURBANCES -- Hypovolaemic shock -- Causes -- Distributive shock -- Causes -- Cardiogenic -- Obstructive -- Septic shock -- Dissociative -- Inotropic and vasoactive substances -- General comments on inotropes -- Mechanism of action -- Catecholamines -- Formulae for drug delivery -- Phosphodiesterase inhibitors -- Other agents with inotropic effects -- Digoxin -- Calcium -- Triiodothyronine (T3) -- CHAPTER 7 SEDATION AND ANALGESIA IN PICU -- Assessment -- Management -- Complications -- Anaesthesia -- Inhalational anaesthesia -- Intra-venous induction -- Sedatives and opiates -- Neuro-muscular blockade -- Regional anaesthetic techniques -- Epidurals -- Nerve blocks -- Simple analgesics -- CHAPTER 8 FLUID, ELECTROLYTES AND NUTRITION -- Assessment -- Sodium -- Hypernatraemia (greater than 150 mmol/l) Causes -- Presentation -- Treatment -- Hyponatraemia Causes -- Symptoms -- Therapy -- Potassium -- Hypokalaemia -- Hyperkalaemia.

Signs and symptoms -- Treatment (see figure 8.1) -- Calcium -- Hypercalcaemia -- Hypocalcaemia -- Magnesium -- Hypermagnesaemia -- Hypomagnesaemia -- Effects -- Treatment -- Phosphate -- Hyperphosphataemia -- Hypophosphataemia -- Acid-base disorders -- Physiology -- Treatment -- Respiratory acidosis -- Respiratory alkalosis -- Metabolic acidosis -- Metabolic alkalosis -- Nutrition -- Nutritional requirements (Table 8.8) -- Enteral nutrition -- Complications -- Total parenteral nutrition -- CHAPTER 9 TRANSPORT OF THE CRITICALLY ILL CHILD -- Hazards of transfer -- Mode of transport -- Staffing -- Equipment -- Communication -- The ambulance journey -- CHAPTER 10 DEATH ON THE PICU -- Withdrawal of intensive care -- Practical cessation of treatment -- Brain stem death -- Post mortem examination -- Donation of organs for transplant -- Following death -- Information -- Section 2 Specific PICU Problems -- CHAPTER 11 RESPIRATORY DISEASE -- Respiratory -- Assessment of severity -- Respiratory rate -- Increased work of respiration -- Effectiveness of breathing -- Effect of respiration on other organs -- Upper airway obstruction -- Croup (laryngotracheobronchitis) -- Treatment -- Epiglottitis -- Management -- Lower airway illnesses Asthma -- Incidence -- Pathophysiology -- Differential diagnosis -- Assessment of severity -- Initial management -- Criteria for intubation -- Ventilation -- Complications of ventilation -- Bronchiolitis -- Aetiology -- Symptoms and signs -- Clinical course -- Management -- Pneumonia -- Diagnosis -- Treatment -- Bacterial -- Whooping cough -- CHAPTER 12 CARDIAC DISEASE ON THE PICU -- Congenital heart disease (CHD) - general points -- Simple pathophysiological classification of congenital heart disease -- Lesions causing primary left-right shunts -- Lesions causing primary right-left shunts -- Lesions obstructing ventricular function.

Left heart -- Right heart -- Shunts -- Left to right shunts, general points -- Right to left shunts and cyanosis -- Specific lesions in CHD -- Patent ductus arteriosus (PDA) (Figure 12.3) -- Transposition of the great arteries (TGA) (Figure 12.4) -- Neonatal arterial 'switch' -- Atrial 'switch' -- Coarctation of the aorta (CoA) (Figure 12.5) -- Neonatal CoA -- Late presentation -- Tetralogy of Fallot (TOF) (Figure 12.6) -- The Fontan circulation -- Fontan - general points (Table 12.2) -- Post-operative cardiac management -- Specific problems following CPB -- Bleeding -- Tamponade -- Low cardiac output -- Pulmonary hypertensive crisis -- Renal dysfunction -- Neurological injury -- CHAPTER 13 DYSRHYTHMIAS AND MYOCARDIAL DISEASE -- Dysrhythmias -- Bradycardias -- Sinus bradycardia -- Conduction abnormalities -- Treatment -- Tachydysrhythmias -- Sinus tachycardia -- Supraventricular tachycardia -- Atrial fibrillation -- Atrial flutter -- Treatment -- Junctional ectopic tachycardia -- Treatment -- Ventricular dysrhythmias -- Premature ventricular contraction -- Ventricular tachycardia -- Treatment -- Cardioversion -- Complications -- Pacing (Table 13.4) -- Methods -- Modes -- Practical points -- Complications -- Myocardial disease -- Ischaemia (Table 13.5) -- Neonatal ischaemic disease -- Kawasaki Disease -- Infections -- Endocarditis -- Post-operative -- Catheter-associated infection -- Viral myocarditis -- Cardiomyopathy -- Hypertension (Table 13.6) -- Treatment -- CHAPTER 14 NEUROLOGICAL AND NEURO-MUSCULAR DISEASE -- Pathophysiology -- Consequences of brain insult -- Examination of the nervous system -- The unconscious child -- Status epilepticus -- Effects -- Management goals -- Investigations -- Supportive treatment -- Other problems -- CNS infections -- Meningitis -- Presentation -- Focal neurological signs -- Assessment.

Prolonged or recurrent fever -- Treatment -- Neonatal meningitis -- Viral encephalitis -- Investigations -- Complications (see also Table 14.13) -- Herpes simplex encephalitis -- Neonates -- Infants and children -- Lumbar puncture -- Reye's syndrome -- Presentation -- Treatment -- Pituitary disorders -- Diabetes insipidus -- Neuro-muscular disease causing respiratory failure -- Tetanus -- Poliomyelitis -- Spinal muscular atrophy -- Guillain-Barre syndrome -- Phrenic nerve injury -- Myasthenia gravis -- Muscular dystrophy -- Critical illness neuropathy -- CHAPTER 15 GASTROINTESTINAL AND HEPATIC DISORDERS -- Bleeding -- Treatment -- Ileus -- Diagnosis -- Treatment -- Diarrhoea -- Treatment -- Malnutrition -- Treatment -- Specific GI problems -- Necrotising enterocolitis -- Treatment -- Gastro-oesophageal reflux -- Treatment -- Intussusception -- Treatment -- Hepatic failure -- Liver function tests -- Hepatic encephalopathy -- Treatment -- Cerebral oedema -- Gastrointestinal bleeding -- Ascites -- Hepatorenal syndrome -- Infections -- Pancreatitis -- Causes -- Clinical features -- Investigations -- Treatment -- CHAPTER 16 RENAL DISEASE -- Acute renal failure (Table 16.1) -- Physiology -- Prevention -- Management -- Fluids -- Electrolytes -- Renal replacement therapy (Table 16.2) -- Peritoneal dialysis -- Advantages -- Complications -- Disadvantages -- Haemodialysis -- Complications -- Plasmafiltration -- Haemofiltration -- CVVH -- Complications -- CAVH -- CVVHD/CAVHD -- Haemolytic-uraemic syndrome -- Complications -- Treatment -- Nephrotic syndrome -- Haemoglobinaemia -- Myoglobinaemia -- CHAPTER 17 HAEMATOLOGY AND ONCOLOGY -- Sickle cell disease -- Leukaemias/tumours -- Tumour lysis syndrome -- Signs -- DIC -- Signs and symptoms -- Treatment -- Bone marrow transplantation -- Pancytopenia -- Infection -- Chemotherapy induced toxicity.

Graft versus host disease (GVHD).