ESSENTIAL OF PAEDIATRIC INTENSIVE CARE

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Essentials of
Paediatric Intensive Care
C G Stack, FRCA
Director of Intensive Care
Sheffield Children’s Hospital
P Dobbs, FRCA
Consultant Anaesthetist
Royal Hallamshire Hospital, Sheffield

cambridge university press
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Cambridge University Press
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Published in the United States of America by Cambridge University Press, New York
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Information on this title: www.cambridge.org/9781841100531
© Greenwich Medical Media Limited 2003
This publication is in copyright. Subject to statutory exception and to the provision of
relevant collective licensing agreements, no reproduction of any part may take place
without the written permission of Cambridge University Press.
First published in print format
isbn-13    978-0-511-16583-2
isbn-10    0-511-16583-8
isbn-13    978-1-841-10053-1
isbn-10    1-841-10053-6
2004
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CONTENTS
Prefacevii
Section 1 Basic Principles of PICU 1
Chapter 1 Differences between the child, the neonate 3
and the adult
Chapter 2 Neonatal problems in the PICU10
Chapter 3 Resuscitation14
Chapter 4 The structured approach to the seriously 20
injured child
Chapter 5 Airway and ventilation24
Chapter 6 Circulation and rhythm disturbances37
Chapter 7 Sedation and analgesia in PICU43
Chapter 8 Fluid, electrolytes and nutrition50
Chapter 9 Transport of the critically ill child61
Chapter 10 Death on the PICU65
Section 2 Specific PICU Problems 69
Chapter 11 Respiratory disease71
Chapter 12 Cardiac disease on the PICU83
Monica Stokes – Birmingham Children’s Hospital
Chapter 13 Dysrhythmias and myocardial disease95
Chapter 14 Neurological and neuro-muscular disease106
Chapter 15 Gastrointestinal and hepatic disorders122
Chapter 16 Renal disease129
Chapter 17 Haematology and oncology134
Chapter 18 Endocrine disorders138
Chapter 19 Inborn errors of metabolism143
Chapter 20 Infection and related illness146
Chapter 21 Trauma155
Chapter 22 Poisoning171
Chapter 23 Neonatal and other surgical patients in PICU176
Section 3 Drugs Used in Paediatric Intensive Care 179
Bibliography 222
Index223

PREFACE
The aim of this book is to be a practical handbook providing easily
accessible information for medical and nursing staff who are involved
in looking after sick children. It is aimed at those who work for a short
time in paediatric intensive care or look after sick children for short
periods prior to retrieval to a paediatric intensive care unit. It is not
intended to be a complete guide but rather a synopsis of the most
salient points. With this in mind, we hope to have written it in an
easily readable form.
The book is in three sections. The first is about basic principles of
intensive care. The second section deals with specific conditions
through different systems.The final section is a section on drugs which
are commonly used in the critically ill child. We apologise for any
omissions.
We would like to thank Dr Monica Stokes from Birmingham
Children’s Hospital for the chapter on Cardiac Problems on the
PICU.We would also like to thank the editorial staff at GMM for their
infinite patience and persistence. Finally we would like to thank Judy
Needham for her secretarial assistance.
C G Stack
P Dobbs
October 2003