Third Edition
Chief Editor
Praveen
Khilnani
MD FICCM FAAP FCCM (USA)
Diplomate American Board of Pediatric Critical Care Medicine
Chair Guidelines Committee 2001 (for IAP and ISCCM )
Senior Consultant and Head
Pediatric Critical Care and Pulmonology
BLK Super Speciality Hospital
New Delhi,
India
Associate Editor
Rajiv
Uttam
MRCP (UK)
Editorial Board
Mritunjay
Pao
MD
Nitesh
Singhal
MD
Rachna
Sharma
MD
Nameet
Jerath
MD
Maninder S
Dhaliwal
MD
Prabhat
Maheshwari
MRCP (UK)
Mritunjay
Pao
MD
Foreword
Janakiraman N
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Practical Approach to Pediatric Intensive Care
First Edition: 2004
Second Edition: 2009
Third Edition: 2015
9789351527398
Printed at
Dedicated to My Mother
Late Smt Laxmi Devi Khilnani
Who left for heavenly abode on May 2001
She always knew I could do it whenever I thought I could not
She was the one who taught me to always be optimistic and hardworking
God will take care of the rest
Contributors
- Agnisekhar Saha md
- Consultant Pediatric Intensivist
- Fortis Hospital
- Kolkata, West Bengal, India
- Inotropes and Vasopressors in the Pediatric Intensive Care Unit
- Ajay Kumar Gupta md
- Associate Consultant
- Fortis Escorts Heart Institute
- New Delhi, India
- Perioperative Management of Transposition of Great Arteries
- Akshay Kapoor md
- Consultant Pediatric Gastroenterologist and Hepatologist
- Indraprastha Apollo Hospital and BLK Hospital
- New Delhi, India
- Liver Transplantation in Children: Indian Scenario
- Amit Gupta md
- Neonatologist and Pediatric Intensivist
- Max Super Speciality Hospital
- Noida, Uttar Pradesh, India
- Assessment and Initial Management: A Practical Approach
- Amita Mahajan md
- Senior Consultant
- Pediatric Hemato-oncologist
- Indraprastha Apollo Hospital
- New Delhi, India
- Immunocompromised Child in the Pediatric Intensive Care Unit
- Amit Varma mbbs
- American Board Certified in Internal Medicine
- (Critical Care Medicine, Perinatal and Neonatal)
- Director, Critical Care
- Fortis Escorts Heart Institute
- New Delhi, India
- Hypertension in Children
- Perioperative Management of Transposition of Great Arteries
- Perioperative Management of Total Anomalous Pulmonary Venous Drainage
- Perioperative Management Strategy of Univentricular Heart
- Anand Bhutada md
- Consultant Pediatric Intensivist
- Child Hospital
- Nagpur, Maharashtra, India
- Respiratory Monitoring in Pediatric Intensive Care Unit
- Anil Sachdev md
- Director, Pediatric Emergency
- Critical Care and Pulmonology
- Department of Pediatrics
- Institute of Child Health—Sir Ganga Ram Hospital
- New Delhi, India
- Cardiac Pacing in Pediatric Intensive Care Unit
- Anita S Bakshi md
- Senior Consultant, Pediatric Intensivist
- and Pulmonologist
- Indraprastha Apollo Hospital
- New Delhi, India
- Acute Liver Failure
- Anjali A Kulkarni md
- Senior Consultant, Neonatologist and Director
- Department of Pediatrics
- Sir HN Reliance Foundation Hospital
- and Research Centre
- Mumbai, Maharashtra, India
- Neonatal Ventilation
- Anupam Sibal md
- Senior Consultant Pediatric
- Gastroenterologist, Hepatologist
- Indraprastha Apollo Hospital
- New Delhi, India
- Liver Transplantation in Children: Indian Scenario
- Bala Ramachandranmd
- Consultant and Head
- Department of Intensive Care and Emergency Medicine
- Kanchi Kamakoti Child Trust Hospital
- Chennai, Tamil Nadu, India
- Pediatric Tracheostomy
- Near-drowning
- Pediatric Brain Death Guidelines
- Bhaskar Saikia md
- Consultant Pediatric Intensivist
- Sri Balaji Action Medical Institute
- New Delhi, India
- Empyema Thoracis in Children
- Disease-specific Ventilation
- Pediatric Head Injury
- Consultant Pediatric Intensivist
- AMRI Group of Hospital
- Kolkata, West Bengal, India
- Inotropes and Vasopressors in the Pediatric
- Intensive Care Unit
- Chhabi Ranu Gupta ms
- Consultant Pediatric Surgery
- Holy Family Hospital
- New Delhi, India
- Multiple Trauma: Stabilization and Management in Pediatric Intensive Care Unit
- David Todres I (Late) md faap fccm
- Professor, Pediatrics, Anesthesia and Critical Care
- Harvard Medical School—Massachusetts General Hospital
- Boston, Massachusetts, USA
- Upper Airway Obstruction in Children
- Deepika Singhal md
- Consultant Pediatric Intensivist
- Pushpanjali Crosslay Hospital
- Ghaziabad, Uttar Pradesh, India
- Neonatal Congenital Lung Lesions
- Basic Mechanical Ventilation
- Pediatric Human Immunodeficiency Viral Infections
- Bacterial, Viral and Fungal Meningitis
- Dhiren Gupta md
- Consultant Pediatric Intensive Care
- Department of Pediatrics
- Sir Gangaram Hospital
- New Delhi, India
- Airway Management
- Cardiac Pacing in Pediatric Intensive Care Unit
- Coma: Encephalitis and Cerebral Malaria
- Dipankar Gupta md
- Fellow Pediatric Cardiology and Critical Care Medicine
- Department of Pediatrics
- Congenital Heart Center
- University of Florida College of Medicine
- Gainesville, Florida, USA
- Pediatric Mechanical Circulatory Support
- Heart Transplantation in Pediatrics
- Ebor Jacob md
- Consultant Pediatric Intensivist
- Christian Medical College (CMC)
- Vellore, Tamil Nadu, India
- Nosocomial Infections and Management
- F arhan Shaikh md
- Consultant Pediatric Intensivist and NABH Consultant
- Rainbow Children Hospital
- Hyderabad, Andhra Pradesh, India
- Transport of Critically Ill Children
- Concept of Quality Improvement in Pediatric Intensive Care Unit
- Frank Zimmerman md
- Assistant Professor
- The University of Chicago Medicine
- Comer Children's Hospital
- Chicago, Illinois, USA
- Pediatric Pacemaker and Implantable Cardioverter-defibrillator Therapy
- Frederick Jay Fricker md
- Professor and Chief
- Division of Pediatric Cardiology, Congenital Heart Center
- University of Florida College of Medicine
- Gainesville, Florida, USA
- Heart Transplantation in Pediatrics
- Gaurav Kharya md
- Consultant Pediatric Hemato-oncologist
- and BMT Specialist
- BLK Centre for Bone Marrow Transplant
- BLK Super Speciality Hospital
- New Delhi, India
- Bone Marrow Transplantation in Children
- Gnanam R md idpccm
- Consultant Pediatric Intensivist and Incharge
- Pediatric Intensive Care Unit
- Manipal Hospital
- Bengaluru, Karnataka, India
- Status Epilepticus
- Giuseppe Marraro md
- Professor of Pediatrics and Anesthesiology
- Ophthalmic Hospital
- Milan, Italy
- Airway Management
- Upper Airway Obstruction in Children
- Gurinder Pal Singh (Late) idpccm
- Consultant Pediatric Intensivist
- BLK Super Speciality Hospital
- New Delhi, India
- Blood Transfusion in Neonatal and
- Pediatric Intensive Care
- Harish Vyas mrcp (UK)
- Consultant Pediatric Intensive Care Unit
- Birmingham, UK
- Viral Pneumonias: Common Pneumonias and Recent Advances
- Consultant Pediatric Intensivist
- Apollo Hospital
- Chennai, Tamil Nadu, India
- Endocrine Emergencies in Critically Ill Children
- Indumathy Santhanam md
- Incharge Pediatric Emergency Care
- Institute of Child Health
- Chennai, Tamil Nadu, India
- Dengue with Shock
- Jai P Udassi md
- Assistant Professor
- Division of Pediatric Cardiology
- Congenital Heart Center
- University of Florida College of Medicine
- Gainesville, Florida, USA
- Heart Transplantation in Pediatrics
- Jashua Caresky md
- Consultant Pediatric Surgeon
- Chippenham, Johnston-Wills Hospital
- Richmond, Virginia, USA
- Multiple Trauma: Stabilization and Management in Pediatric Intensive Care Unit
- Jeffrey C Benson md
- Pediatric Intensivist
- Children's Hospital of Wisconsin
- Wisconsin, Michigan, USA
- High-frequency Ventilation
- Jesal Sheth md
- Consultant Pediatric Intensivist and Neonatologist
- Fortis Hospital
- Mumbai, Maharashtra, India
- Common Congenital Heart Defects and Perioperative Issues
- Jhuma Sankar md
- Associate Professor
- Department of Pediatrics
- All India Institutes of Medical Sciences (AIIMS)
- New Delhi, India
- Role of Echocardiography in the Pediatric Intensive Care Unit
- John M Downey md
- Assistant Professor
- The University of Chicago Medicine
- Comer Children's Hospital
- Chicago, Illinois, USA
- Liver Transplantation
- Jose Irazzuzta md
- Director Pediatric ICU
- Wolfson Children's Hospital
- Jacksonville, Florida, USA
- Bacterial, Viral and Fungal Meningitis
- Jyotinder Kaur md
- Head, Department of Pediatrics
- Apollo Hospital
- Ahmedabad, Gujarat, India
- Flexible Bronchoscopy in Infants and Children
- Sedation, Analgesia and Neuromuscular Blockade
- Kala Ebnezar md
- Consultant Pediatric intensivist
- Christian Medical College (CMC)
- Vellore, Tamil Nadu, India
- Nosocomial Infections and Management
- Kanav Anand mbbs md Pediatrics Fellowship in Pediatric Nephrology
- Pediatric Nephrologist
- Division of Pediatric Nephrology
- Institute of Child Health—Sir Ganga Ram Hospital
- New Delhi, India
- Acute Kidney Injury in Children and Renal Replacement Therapy
- Pediatric Renal Transplantation
- Krishan Chugh md
- Director Pediatrics
- Pediatric Pulmonologist and Intensivist
- Fortis Memorial Research Institute
- Gurgaon, Haryana, India
- Coma: Encephalitis and Cerebral Malaria
- Leticia Castillo md fccm
- Associate Professor
- Pediatric Intensive Care Unit
- Baylor College of Medicine Houston
- Texas, USA
- Pediatric Septic Shock
- Madelyn Kahana md
- Director, Pediatric Intensive Care Unit
- The University of Chicago Medicine
- Comer Children's Hospital
- Chicago, Illinois, USA
- Pediatric Pacemaker and Implantable Cardioverter-Defibrillator Therapy
- Liver Transplantation
- Madhulika Kabra md
- Department of Pediatrics
- All India Institutes of Medical Sciences (AIIMS)
- New Delhi, India
- Cystic Fibrosis: Clinical Manifestations and Treatment
- Senior Consultant and Incharge
- Department of Transfusion Medicine
- Indraprastha Apollo Hospital
- New Delhi, India
- Blood Transfusion in Neonatal and Pediatric Intensive Care
- Mallikarjun RP md dch
- Assistant Professor Pediatrics
- Fellowship in Pediatric Intensive Care
- AJ Institute of Medical Sciences
- Mangaluru, Karnataka, India
- Malaria
- Mani RK md
- Senior Consultant
- Respiratory and Critical Care Medicine
- Saket City Hospital
- New Delhi, India
- Ethical Issues Related to End-of-life
- Maninder S Dhaliwal md
- Consultant Pediatric Intensivist
- Medanta—The Medicity Hospital
- Gurgaon, Haryana, India
- Hemodynamic Monitoring in Pediatric Intensive Care Unit
- Procedures in Pediatric Intensive Care Unit
- Manish Malik mrcp (UK)
- Consultant Neonatologist
- Max Super Speciality Hospital
- New Delhi, India
- Meconium Aspiration Syndrome and Persistent Pulmonary Hypertension of Newborn
- Manish Vaish ms
- Senior Registrar Neurosurgery
- Sir Ganga Ram Hospital
- New Delhi, India
- Hydrocephalus
- Mark S Bleiweis md
- Professor and Cardiothoracic Surgeon
- Director Congenital Heart Center
- University of Florida College of Medicine
- Gainesville, Florida, USA
- Heart Transplantation in Pediatrics
- Meera Luthra mch (Pediatric Surgery)
- Senior Consultant
- Pediatric Surgeon
- Holy Family Hospital and Medanta—The Medicity Hospital
- New Delh, India
- Neonatal Congenital Lung Lesions
- Multiple Trauma: Stabilization and Management in Pediatric Intensive Care Unit
- Perioperative Anesthetic and Surgical Issues
- Meera Ramakrishnan md
- Pediatric Intensivist and Emergency Incharge
- Manipal Hospital
- Bengaluru, Karnataka, India
- Care of the Ventilated Patient
- Michael A Maymi cpnp-ac
- PICU Nurse Practitioner
- Department of Pediatrics
- University of Florida
- Gainesville, Florida, USA
- Pediatric Mechanical Circulatory Support
- Mosharraf Shamim md
- Consultant Pediatric Intensivist
- King Fahd Hospital
- Saudi Arabia
- Cardiac Arrhythmias in Pediatric Intensive Care Unit
- Intensive Care Unit-acquired Weakness
- Mritunjay Pao md
- Consultant Pediatric Intensivist and Neonatologist
- Sanjeevani Hospital
- Jorhat, Assam, India
- Flexible Bronchoscopy in Infants and Children
- Basic Mechanical Ventilation
- Status Epilepticus
- Mukesh Desai md
- Consultant Pediatric Hemato-oncologist
- Bai Jerbai Wadia Hospital for Children
- Mumbai, Maharashtra, India
- Immunocompromised Child in the Pediatric Intensive Care Unit
- Nameet Jerath md
- Senior Consultant Pediatric Intensivist
- and Pulmonologist
- Indraprastha Apollo Hospital
- New Delhi, India
- Cardiogenic Shock
- Acute Liver Failure
- Neeraj Gupta md
- Consultant Pediatric Critical Care
- Department of Pediatrics
- Institute of Child Health
- Sir Ganga Ram Hospital
- Cardiac Pacing in Pediatric Intensive Care Unit
- Nitesh Singhal md
- Consultant
- Pediatric Intensive Care Unit
- The Hospital for Sick Children
- Toronto, Canada
- Inborn Errors of Metabolism
- Pediatric Gastroenterologist
- Max Healthcare
- New Delhi, India
- Parenteral Nutrition for the Pediatrician
- Pooja Verma ms
- Clinical Psychologist
- Fellow Social Research Methods
- The London School of Economics and Political Science
- London, UK
- Psychological Issues in Pediatric Intensive Care Unit
- Prabhat Maheshwari mrcp (UK)
- Incharge
- Consultant Pediatric Intensivist
- Artemis Hospital
- Gurgaon, Haryana, India
- Acute Respiratory Distress Syndrome in Children
- Pradeep Sharma md
- Consultant Pediatric Intensivist
- Sri Balaji Action Medical Institute
- New Delhi, India
- Oxygen Therapy in Pediatrics
- Empyema Thoracis in Children
- Poisoning and Bites
- Pranay Oza ms
- Senior Perfusionist and ECMO Specialist
- Incharge Extracorpreal Membrane Oxygenation (ECMO) Program
- Riddhivinayak Cardiac Centre
- Mumbai, Maharashtra, India
- Extracorporeal Membrane Oxygenation
- Prasanna C Tellis md
- Consultant Pediatric Cardiology
- Narayana Hrudyalaya
- Bengaluru, Karnataka, India
- Hypertension in Childrenn
- Prashant Jai mch (Pediatric Surgery)
- Consultant Pediatric Surgery
- BLK Super Speciality Hospital
- New Delhi, India
- Pediatric Thoracoscopy
- Empyema Thoracis in Children
- Prashant Pruthi md
- Consultant Pediatric Intensive Care
- Sydney Children's Hospital
- NSW, Australia
- Hypertension in Children
- Disseminated Intravascular Coagulation
- Praveen Khilnani md ficcm faap fccm (USA)
- Diplomate American Board of Pediatric Critical Care Medicine
- Chair Guidelines Committee 2001 (for IAP and ISCCM)
- Senior Consultant and Head
- Pediatric Critical Care and Pulmonology
- BLK Super Speciality Hospital
- New Delhi, India
- Assessment and Initial Management: A Practical Approach
- Airway Management
- Consensus Guidelines for Pediatric Intensive Care Units in India
- Nursing Care in the Pediatric Intensive Care Unit
- Procedures in Pediatric Intensive Care Unit
- Flexible Bronchoscopy in Infants and Children
- Ultrasound in Pediatric Intensive Care Unit
- Respiratory Physiology
- Oxygen Therapy in Pediatrics
- Blood Gas and Acid-base Interpretation
- Upper Airway Obstruction in Children
- Meconium Aspiration Syndrome and Persistent Pulmonary Hypertension of Newborn
- Acute Respiratory Failure
- Acute Severe Asthma Management in Pediatric Intensive Care Unit
- Viral Pneumonias: Common Pneumonias and Recent Advances
- Persistent and Recurrent Pneumonias
- Recent Advances in the Rapid Diagnosis of Respiratory Tract Infection
- Human Immunodeficiency Virus Disease and Respiratory Infection in Children
- Acute Respiratory Distress Syndrome in Children
- >Empyema Thoracis in Children
- Neonatal Congenital Lung Lesions
- Bronchodilator Therapy in Mechanically Ventilated Children
- Basic Mechanical Ventilation
- Commonly Available Ventilators
- Disease-specific Ventilation
- Advanced Mechanical Ventilation
- Ventilator Graphics and Clinical Applications
- Weaning from Mechanical Ventilation
- Complications of Mechanical Ventilation
- High-frequency Ventilation
- Inhaled Nitric Oxide
- Extracorporeal Membrane Oxygenation
- Shock: Management in Pediatric Intensive Care Unit
- Pediatric Septic Shock
- Multiorgan Failure in Critically Ill Children
- Role of Echocardiography in the Pediatric Intensive Care Unit
- Cardiac Arrhythmias in Pediatric Intensive Care Unit
- Common Congenital Heart Defects and Perioperative Issues
- Pediatric Pacemaker and Implantable Cardioverter-defibrillator Therapy
- Diabetic Ketoacidosis
- Gastrointestinal Bleeding: Diagnosis and Management
- Liver Transplantation
- Nutrition in the Pediatric Intensive Care Unit
- Blood Transfusion in Neonatal and Pediatric Intensive Care
- Pediatric Human Immunodeficiency Virus Infections
- Bone Marrow Transplantation in Children
- Antibiotic Therapy in the Pediatric Intensive Care Unit
- Multiple Trauma: Stabilization and Management in Pediatric Intensive Care Unit
- Child Abuse and Shake Injuries
- Perioperative Anesthetic and Surgical Issues
- Poisoning and Bites
- Thermal Burns
- Bacterial, Viral and Fungal Meningitis
- Hydrocephalus
- Status Epilepticus
- Pediatric Head Injury
- Sedation, Analgesia and Neuromuscular Blockade
- Intensive Care Unit-acquired Weakness
- Care of Terminally Ill Children
- Psychosocial Issues in Pediatric Intensive Care Unit
- Ethical Issues Related to End-of-life
- Training in Pediatric Critical Care Medicine
- Simulation-based Training in Pediatric Intensive Care
- Research in the Pediatric Intensive Care Unit
- Drugs Used in the Pediatric Intensive Care Unit
- Preetha Joshi md
- Consultant Pediatric Intensivist and Neonatologist
- Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute
- Mumbai, Maharashtra, India
- Myocarditis in Children
- Fluid and Electrolyte Abnormalities in the Critically Ill Children
- Priyanka Sharma dnb fnb
- Consultant Pediatric Hemato-oncologist
- Christian Medical College (CMC)
- Ludhiana, Punjab, India
- Immunocompromised Child in the Pediatric IntensiveCare Unit
- Pruthi PK mbbs md (Pediatrics) mnams
- Senior Pediatric Nephrologist
- Division of Pediatric Nephrology
- Institute of Child Health
- Sir Ganga Ram Hospital
- New Delhi, India
- Acute Kidney Injury in Children and Renal Replacement Therapy
- Pediatric Renal Transplantation
- Purnima Dhar md
- Senior Consultant Anesthesia
- Indraprastha Apollo Hospital
- New Delhi, India
- Heat Disorders
- Rachna Sharma md
- Consultant Pediatric Intensivist
- BLK Super Speciality Hospital
- New Delhi, India
- Procedures in Pediatric Intensive Care Unit
- Empyema Thoracis in Children
- Bone Marrow Transplantation in Children
- Rajesh Chawla md
- Senior Consultant
- Respiratory and Critical Care Medicine
- Indraprastha Apollo Hospital
- New Delhi, India
- Bronchodilator Therapy in Mechanically Ventilated Children
- Rajesh Mehta md
- Professor of Pediatrics and Consultant
- World Health Organization, New Delhi, India
- Disseminated Intravascular Coagulation
- Rajesh Sharma ms mch (Cardiothoracic Surgery)
- Director and Head
- Pediatric Cardiac Surgery
- Fortis Escorts Heart Institute & Research Centre
- New Delhi, India
- Perioperative Management of Transposition of Great Arteries
- Perioperative Management of Total Anomalous Pulmonary Venous Drainage
- Perioperative Management Strategy of Univentricular Heart
- Rajiv Uttam mrcp (UK)
- Senior Consultant
- Pediatric Intensivist and Pulmonologist
- Max Super Speciality Hospital
- New Delhi, India
- Non-invasive Ventilation
- Multiorgan Failure in Critically Ill Children
- Additional Professor
- Department of Pediatrics
- All India Institutes of Medical Sciences (AIIMS)
- New Delhi, India
- Air Leak Syndromes
- Cystic Fibrosis: Clinical Manifestations and Treatment
- Rakshay Shetty md
- Consultant Pediatric Intensivist
- Rainbow Children's Hospital
- Bengaluru, Karnataka, India
- Intracranial Pressure Monitoring
- Simulation-based Training in Pediatric Intensive Care
- Ramesh S md
- Pediatric Anesthesiologist
- Kanchi Kamakoti Child Trust Hospital
- Chennai, Tamil Nadu, India
- Commonly Available Ventilators
- Perioperative Anesthetic and Surgical Issues
- Ramesh Sachdeva md mba
- Pediatric Intensivist and Vice President
- Children's Hospital of Wisconsin
- Wisconsin, Michigan, USA
- High-frequency Ventilation
- Ravi R Thiagarajan mbbs mph
- Senior Associate in Cardiology
- Department of Cardiology
- Cardiac Intensive Care Unit
- Boston Children's Hospital
- Associate Professor of Pediatrics
- Harvard Medical School
- Boston, MA, USA
- Postoperative Care of Cardiac Patients After
- Open Heart Surgery
- Reeta Singh md
- Consultant Pediatrics
- Royal Children's Hospital
- Melbourne, Australia
- Inhaled Nitric Oxide
- Nutrition in the Pediatric Intensive Care Unit
- Ricardo Munoz md
- Director, Cardiac Intensive Care Unit
- Children's Hospital of Pittsburgh
- Pittsburgh, Pennsylvania, USA
- Blood Gas and Acid-base Interpretation
- Sagar Lad md
- Consultant Pediatric Intensivist and Neonatologist
- Jehangir Hospital
- Pune, Maharashtra, India
- Drugs Used in the Pediatric Intensive Care Unit
- Sandeep Chopra mch (Neurosurgery)
- Consultant Pediatric Neurosurgery
- Sir Ganga Ram Hospital
- New Delhi, India
- Hydrocephalus
- Pediatric Head Injury
- Sankaran Krishnan md
- Pediatric Pulmonologist
- Cornell University Medical Center
- New York, USA
- Weaning from Mechanical Ventilation
- Sanjeev Sharma md
- Associate Consultant Pediatric Hemato-oncologist
- and BMT Specialist
- BLK Center for Bone Marrow Transplant
- BLK Super Speciality Hospital
- New Delhi, India
- Bone Marrow Transplantation in Children
- Santosh T Soans md dch fiap
- Professor and Head, Department of Pediatrics
- AJ Institute of Medical Sciences
- Mangaluru, Karnataka, India
- Malaria
- Satish Deopujari md
- Consultant Pediatric Intensivist
- Central India's Child Hospital and Research Institute
- Nagpur, Maharashtra, India
- Oxygen Therapy in Pediatrics
- Seth RK mch (Plastic Surgery)
- Senior Consultant Plastic Surgery
- Indraprastha Apollo Hospital
- New Delhi, India
- Thermal Burns
- Shekhar T Venkataraman md
- Professor, Department of Critical Care Medicine
- and Pediatrics
- University of Pittsburgh School of Medicine
- Medical Director, Respiratory Care Services
- Children's Hospital of Pittsburgh
- Pittsburgh, Pennsylvania, USA
- Basic Mechanical Ventilation
- Pediatric Heart and Lung Transplantation
- Shipra Gulati md
- Consultant Pediatric Intensivist
- Max Super Speciality Hospital
- Patparganj, New Delhi, India
- Non-invasive Ventilation
- Senior Consultant Pediatrics
- NHS, Birmingham, UK
- Pediatric Human Immunodeficiency Virus Infections
- Shushil Kabra md
- Professor
- Department of Pediatrics
- All India Institute of Medical Sciences (AIIMS)
- New Delhi, India
- Cystic Fibrosis: Clinical Manifestations and Treatment
- Sidharth Luthra llb
- Senior Advocate
- Supreme Court and Additional Solicitor
- General (ASG) of India
- New Delhi, India
- Medicolegal Issues in Intensive Care
- Sister Gracey bsc (Nursing)
- Head Nurse PICU
- Acting Director, Nursing
- Indraprastha Apollo Hospital
- New Delhi, India
- Nursing Care in the Pediatric Intensive Care Unit
- Soonu Udani md
- Head, Department of Pediatrics and Consultant
- Pediatric Intensivist
- PD Hinduja Hospital
- Mumbai, Maharashtra, India
- Electrical Shock
- Suchita Khadse md
- Consultant Pediatric Intensivist
- Central India's Child Hospital and Research Institute
- Nagpur, Maharashtra, India
- Poisoning and Bites
- Suchitra Ranjit md
- Pediatric Intensivist Incharge
- Apollo Hospitals
- Chennai, Tamil Nadu, India
- Oxygen Therapy in Pediatrics
- Sujatha Thyagarajan md
- Consultant Pediatric Intensivist
- HCG Hospital
- Bengaluru, Karnataka, India
- Simulation-based Training in Pediatric Intensive Care
- Sukhmeet Singh md
- Consultant Pediatrics
- Dayananda Medical College & Hospital
- Ludhiana, Punjab, India
- Diabetic Ketoacidosis
- Sune el Pooboni md mrcp (UK)
- Head, Department of Pediatric ICU and ECMO
- Program
- KIMS Hospital
- Hyderabad, Telangana, India
- Extracorporeal Membrane Oxygenation
- Sunil Gomber md
- Professor and Head
- Department of Pediatrics
- Guru Teg Bahadur Hospital
- New Delhi, India
- Methemoglobinemia
- Suresh Panda md
- Consultant Pediatric Intensivist
- Rainbow Children Hospital
- Hyderabad, Andhra Pradesh, India
- Intracranial Pressure Monitoring
- Taneja LN md
- Consultant
- Department of Pediatrics
- PAST National Convener
- IAP ALS Group
- Max Super Speciality Hospital
- Patparganj, New Delhi, India
- Cardiopulmonary Resuscitation:
- 2010 Guidelines Summary
- Ted A Williams md
- Pediatric Gastroenterologist
- St Mary's Hospital
- Richmond, Virginia, USA
- Gastrointestinal Bleeding: Diagnosis and Management
- Thangavelu S md
- Consultant Pediatric Intensivist Incharge
- Dr Mehta's Children's Hospital
- Chennai, Tamil Nadu, India
- Dengue with Shock
- Thomas Albrecht G md
- Pediatric Cardiologist
- Chippenham and Johnston-Willis Hospital
- Richmond, Virginia, USA
- Interventional Pediatric Cardiology: An Overview
- Utkarsh Kohli md
- Consultant Pediatric Intensivist
- The University of Chicago Medicine
- Comer Children's Hospital
- Chicago, Illinois, USA
- Air Leak Syndromes
- 15Uttar a Babbar llb
- Advocate
- Supreme Court of India
- New Delhi, India
- Medicolegal Issues in Intensive Care
- Verma IC md
- Incharge
- Department of Genetics and Metabolic Disorders
- Sir Ganga Ram Hospital
- New Delhi, India
- Inborn Errors of Metabolism
- Vidya Gupta mrcp(UK)
- Senior Consultant Neonatologist
- Indraprastha Apollo Hospital
- New Delhi, India
- Surfactant Therapy in Newborn
- Vidyut Bhatia md
- Consultant Pediatric Gastroenterologist
- and Hepatologist
- Indraprastha Apollo Hospital
- New Delhi, India
- Liver Transplantation in Children: Indian Scenario
- Vikram Gagneja md
- Consultant Pediatric Intensivist
- Max Super Speciality Hospital
- New Delhi, India
- Ultrasound in Pediatric Intensive Care Unit
- Pediatric Septic Shock
- Vinayak K Patki md
- Consultant Pediatric Intensivist
- Wanless Hospital
- Miraj, Maharashtra, India
- Drugs Used in the Pediatric Intensive Care Unit
- Vinay Joshi md
- Consultant Pediatric Intensivist and Neonatologist
- Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute
- Mumbai, Maharashtra, India
- Myocarditis in Children
- Fluid and Electrolyte Abnormalities
- in the Critically Ill Children
- Vinay Ku kreti md
- Consultant Pediatric Intensivist
- The Hospital for Sick Children
- Toronto, Canada
- Cardiac Arrhythmias in Pediatric Intensive Care Unit
- Intensive Care Unit-acquired Weakness in Children
- Vinay K Aggarwal mrcp (UK)
- Senior Consultant, Pediatric Nephrologist
- Max and BLK Super Speciality Hospitals
- New Delhi, India
- Inborn Errors of Metabolism
- Vishal K Singh dch md dnb (Pediatrics)
- Senior Consultant, Pediatric Cardiac Care
- Fortis Escorts Heart Institute & Research Centre
- New Delhi, India
- Perioperative Management of Transposition of Great Arteries
- Perioperative Management of Total Anomalous Pulmonary Venous Drainage
- Perioperative Management Strategy of Univentricular Heart
- Vishram B Buche md
- Consultant Pediatric Intensivist
- Central India's Child Hospital and Research Institute
- Nagpur, Maharashtra, India
- Respiratory Monitoring in Pediatric Intensive Care Unit
- Wendy E Barnes cpnp-ac
- PICU Nurse Practitioner
- Department of Pediatrics
- University of Florida
- Gainesville, Florida, USA
- Pediatric Mechanical Circulatory Support
- Yogesh Govil (Late) md
- Professor
- Department of Pediatrics
- King George's Medical University
- Lucknow, Uttar Pradesh, India
- Acute Respiratory Failure
- Zahid Hussain md
- Fellow Pediatric Intensive Care
- BLK Super Speciality Hospital
- New Delhi, India
Pediatric critical care is a relatively new subspecialty and has developed rapidly in many parts of the world. In India,
it is still in infancy, but over the last few years, it has made great strides. The standard of care for the critically ill or
injured child is more or less at par with other countries. It is very gratifying to see that many institutions have excellent
pediatric intensive care units with current state of the art. The Indian Society of Critical Care Medicine and the Indian
Academy of Pediatrics are to be commended for their lead and enormous input to disseminate the knowledge and
skills to physicians, nurses and other healthcare personnel. With the explosion in current technology and monitoring
techniques, many lives are being saved.
This book entitled Practical Approach to Pediatric Intensive Care edited by Dr Praveen Khilnani, Senior Consultant
and Head, Pediatric Critical Care and Pulmonology, BLK Super Speciality Hospitals, New Delhi, India, will be a valuable
companion to all the medical and nursing personnel. Many areas and topics have been covered well by the author who
is well experienced to conditions that prevail the world over.
A book like this cannot be exhaustive and complete. But, it contains practical guidance for the routine daily care of
the sick child. I commend the editor for his efforts and venture.
Janakiraman N MD FAAP FCCM (USA)
Professor
Pediatrics and Critical Care
University of Illinois
Cook County Health and Hospitals System
Chicago, Illinois, USA
Preface to the Third Edition
Since the publication of the first edition in 2004, the field of pediatric critical care has grown by leaps and bounds, newer developments and guidelines have emerged. New resuscitation guidelines (AHA PALS, 2010) as well as International Surviving Sepsis Guidelines (2012) have been included, in addition to overall upgrading of latest information and technology in the field of pediatric critical care. Pediatric intensive care delivery is cost intensive and can be a limiting factor in resource-limited countries, such as India. Resource limitations have been particularly kept in mind, while discussing various treatment and investigative modalities. Practice-oriented flowcharts have been updated in several chapters for giving a quick overview of management of common pediatric intensive care unit problems.
I hope that this book Practical Approach to Pediatric Intensive Care will emerge as truly practical companion to doctors and nurses at various levels of training, consultants in teaching programs, and also in corporate practice of pediatric critical care in saving lives of critically ill children.
Preface to the First Edition
The field of pediatric critical care (pediatric intensive care) is rapidly advancing, and new innovations and technologies are being frequently incorporated into the delivery of pediatric critical care. The role of the pediatric critical care specialist (pediatric intensivist) has become more defined as pediatrician who specializes in the field of diagnosis of critical pediatric illnesses and prompt management employing all the principles of pediatric pathophysiology, including hemodynamic disturbances, tissue oxygen delivery, septic process, trauma and surgical stress, and systemic inflammatory response syndrome (SIRS). Treatment of critical illness involves a good grasp on ways to improve the oxygen delivery for management of shock, respiratory failure and sepsis. Clinical reserve in a pediatric patient is far less compared to an adult patient; therefore, a timely detection of a clinically deteriorating patient as well as a prompt institution of appropriate resuscitative efforts goes a long way. A pediatric intensivist must be well trained in emergency procedures, such as central line placement, endotracheal intubation, bag-mask ventilation, arterial line placement, sedation, ventilator management, chest tube placement, lumbar puncture, oxygen therapy, cardiopulmonary resuscitation, intraosseous line placement, and above all the application of appropriate clinical judgment to use the above skills effectively and safely to improve patient outcome.
This book has been written and edited to emphasize practical aspects of pediatric intensive care contributed by various national and international authors involved in routine day-to-day management in the multidisciplinary pediatric intensive care unit with collaboration of a team of specialists including medical, surgical, nursing and other important ancillary services. Ethical, legal and nursing issues have also been included. I sincerely hope this book will be a resource to those practicing and training in the field of pediatric critical care medicine.
The effort has been made to present currently accepted consensus on therapy rather than dogmatic opinions. I wish to thank all the contributors and my family members for their unconditional support.
Praveen Khilnani
35Development of Pediatric Critical Care
1889 : First infant respirator, Egon Braun, Vienna
1910 : First positive pressure ventilator
1954 : Extracorporeal circulation described
1954 : First PICU, Gothenburg, Sweden
Closed chest defibrillation described
ECMO described
1957 : Severinghaus electrode: led to blood gas analysis
1958 : First physician-directed multidisciplinary adult ICU, Baltimore City Hospital
1963 : First liver transplant
1964 : Theodore Striker becomes first pediatric critical care fellow, Philadelphia
1967 : First US physician-directed PICU, Philadelphia
Society of Critical Care Medicine (SCCM) established
1972 : First US Textbook of Pediatric Critical Care, Clement Smith (Editor)
1973 : First edition, Critical Care Medicine (CCM), William Shoemaker
1974 : Pulse oximetry developed
1982 : Pediatric Section of Society of Critical Care Medicine established
1983 : First pediatric advanced life support (PALS) copy written
Formation of Section on Critical Care of AAP
1986 : US Guidelines published for pediatric air and ground transport
1987 : First comprehensive Textbook of Pediatric Critical Care, MC Rogers
First Pediatric Critical Care Board examinations
1988 : American College of Critical Care Medicine (ACCM) established
Prism score described by Murray Pollack
1989 : First Pediatric Critical Care Fellowship certified by American College of Graduate Medical Education (ACGME)
1993 : US Guidelines and Levels of Care for PICUs published
1993 : Indian Society of Critical Care Medicine (ISCCM) established, Mumbai
1993 : First Indian Academy of Pediatrics (IAP) Intensive Care Conference, New Delhi
Manual of Pediatric Intensive Care published, K Chugh and Praveen Khilnani
1997 : World Congress and establishment of World Federation of Pediatric Intensive Care (WFPICC), Baltimore
1998 : IAP Intensive Care Chapter established by Krishan Chugh
1998 : First National Congress on Pediatric Intensive Care, Nagpur
2000 : ISCCM Pediatric Section formed, Founder Chair Praveen Khilnani
2001 : IAP and ISCCM PICU Guidelines and Levels of Care published
2002 : First Pediatric Critical Care Fellowship started
2003 : First Pediatric Critical Care Fellowship examination, Surat, Gujarat
2004 : First comprehensive Indian textbook on Pediatric Intensive Care, Praveen Khilnani
2007 : DNB Training In Pediatric Critical Care started in India
2009 : Basic Pediatric Intensive Care Course (BPICC) developed by IAP (Intensive Care Chapter) and ISCCM Pediatric Section
2010 : DM training in Pediatric Critical Care Medicine started at PGIMER, Sunit Singhi, Chandigarh
2014 : IAP Intensive Care Journal started, Journal of Pediatric Critical Care (JPCC), Editor-in-Chief Praveen Khilnani
2014 : Formation of College of Pediatric Critical Care, India
2015 : Advanced Pediatric Intensive Care Course (APICC) by College of Pediatric critical care, India