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Pediatric resuscitation medicine has witnessed significant advances with improved understanding of the pathophysiology of cardiac arrest and resuscitation. Multiple mechanisms of neurological injury have been identified, outlining potential avenues for neuroprotection following cardiac arrest. Resuscitation science exists at multiple levels of analysis, from biomechanics of chest compressions to implementation of best training procedures in real time, from epidemiology of cardiac arrest survival to molecular mechanisms of cellular injury due to ischemia and reperfusion. What next steps in research and in clinical practice will ensure the best possible neurologic outcome among children who survive cardiac arrest? How can we leverage novel technologies in neuroimaging, nanomaterials, drug delivery, biomarker-based risk stratification and next generation sequencing, among others, to resuscitate and to protect the Central Nervous System (CNS)? How can we improve clinical trial design and data analyses to maintain a robust clinical research infrastructure and to ensure validity and applicability? These are just some of the questions will addressed in this Research Topic. Using evidence-based algorithms and public health approaches to disseminate them, the last decade has seen a paradigm shift in pediatric resuscitation with significantly improved survival from pediatric cardiac arrests. However, neurologic outcome in survivors remains far from optimal. High quality CPR is increasingly recognized as a key factor for improving neurologic outcomes. Advanced technologies allow monitoring the quality of CPR and just-in-time feedback to improve the quality of CPR. Further research is needed to evaluate impact of these technologies on neurologic outcome. The recent American Heart Association CPR guidelines emphasis on Circulation-Airway-Breathing (CAB) approach to CPR needs a careful evaluation in children, in whom timely airway and breathing support are as important as circulation. The growing controversy regarding use of epinephrine, and alternative routes of administration of epinephrine during CPR, warrants further evaluation in the setting of pediatric CPR. Improved outcome of hemodynamic goal-directed CPR over standard CPR in animal models of cardiac arrest has initiated interest in physiology-based CPR, especially in the in-hospital cardiac arrest. Basic and applied-science research have become relevant for specific subpopulations of pediatric cardiac arrest victims and circumstances (e.g., ventricular fibrillation, neonates, congenital heart disease, extracorporeal cardiopulmonary resuscitation). Just-in-time and just-in-place simulation training, which have evolved as training strategies to improve quality of CPR, are being evaluated for outcomes. The concept of just-in-time and just-in-place coaching of CPR providers on high quality CPR is a novel concept which has emerged recently and remains unstudied. Whilst there have been significant advances in newborn stabilization over the last decade many questions remain unanswered. These include the role of delayed cord clamping in preterm infants and term newborns requiring resuscitation, the role of sustained inflations as a method of respiratory support and the role of epinephrine and volume administration in neonatal resuscitation. Novel methods of assessment including the use of end tidal CO2 monitoring, respiratory function monitoring and near infrared spectroscopy warrant further evaluation. The use of transitioning animal models that accurately replicate the newborn circulation with patent fetal shunts are emerging but more assessments in these are required to better establish CPR strategies in newborn infants. Newborn resuscitation training programs have resulted in a reduction in neonatal mortality in the developing world, but key questions remain around the frequency of training, team training methods and the role of simulation training. Post resuscitation interventions, in particular therapeutic hypothermia, has resulted in significant improvements in long-term outcome and there is now a growing interest in adjunct therapies, such as use of melatonin, erythropoietin, or other neuroprotective molecules to improve therapeutic benefits of cooling. Therapeutic hypothermia did not provide any higher benefit than normothermia in children following out of hospital cardiac arrest, although three is considerable debate in the community whether 14% probability of observing a similar outcome if the study were repeated a 100 times applies to an individual child in the PICU. Exciting research is occurring in unraveling connection between inflammation, immune dysregulation and neuroinjury. This will further support research on the use of anti-inflammatory agents and immunomodulators for neuroprotection after cardiac arrest and birth asphyxia.
Extensively updated and featuring a new editorial team, the 6th Edition of Assisted Ventilation of the Neonate, by Drs. Jay P. Goldsmith, Edward Karotkin, Gautham Suresh, and Martin Keszler, continues to be a must-have reference for the entire NICU. Still the only fully comprehensive guide in this fast-changing area, it provides expert guidance on contemporary management of neonatal respiratory diseases, with an emphasis on evidence-based pharmacologic and technologic advances to improve outcomes and quality of life in newborns. A new full-color design and chapter layout combine for quick and easy reference. Covers everything you need to know about respiratory management in neonates: general principles and concepts; assessment, diagnosis and monitoring methods; therapeutic respiratory interventions; adjunctive interventions; and special situations and outcomes. Covers basic concepts of pulmonary pathophysiology and gives practical guidance on providing neonatal respiratory support with a variety of techniques, so you can learn both basic and advanced methods in one volume. Offers more than 30 appendices that help you quickly find normal values, assessment charts, ICU flow charts, procedure steps and other useful, printable forms. Reflects the rapid evolution of approaches to respiratory care, including the shift to non-invasive support, as well as changes in oxygenation targets, high-flow nasal therapy, volume ventilation, and sophisticated microprocessor-controlled ventilators. Completely new information on many previously covered topics, including ethical and legal issues related to neonatal mechanical ventilation. Features 11 entirely new chapters, including Radiography, Lung Ultrasound and Other Imaging Modalities; Non-invasive Monitoring of Gas Exchange; Airway Evaluation: Bronchoscopy, Laryngoscopy, Tracheal Aspirates; Special Ventilation Techniques; Cardiovascular Therapy and PPHN; and Quality Improvement in Respiratory Care . Includes new opening summaries that highlight key information in each chapter.
A clear, engaging writing style, hundreds of full-color images, and new information throughout make Volpe's Neurology of the Newborn, 6th Edition, an indispensable resource for those who provide care for neonates with neurological conditions. World authority Dr. Joseph Volpe, along with Dr. Terrie E. Inder and other distinguished editors, continue the unparalleled clarity and guidance you've come to expect from the leading reference in the field – keeping you up to date with today's latest advances in diagnosis and management, as well as the many scientific and technological advances that are revolutionizing neonatal neurology. - Provides comprehensive coverage of neonatal neurology, solely written by the field's founding expert, Dr. Joseph Volpe - for a masterful, cohesive source of answers to any question that arises in your practice. - Focuses on clinical evaluation and management, while also examining the many scientific and technological advances that are revolutionizing neonatal neurology. - Organizes disease-focused chapters by affected body region for ease of reference. - Features a brand new, full-color design with hundreds of new figures, tables, algorithms, and micrographs. - Includes two entirely new chapters: Neurodevelopmental Follow-Up and Stroke in the Newborn; a new section on Neonatal Seizures; and an extensively expanded section on Hypoxic-Ischemia and Other Disorders. - Showcases the experience and knowledge of a new editorial team, led by Dr. Joseph Volpe and Dr. Terrie E. Inder, Chair of the Department of Pediatric Newborn Medicine at Brigham and Women's Hospital, all of whom bring a wealth of insight to this classic text. - Offers comprehensive updates from cover to cover to reflect all of the latest information regarding the development of the neural tube; prosencephalic development; congenital hydrocephalus; cerebellar hemorrhage; neuromuscular disorders and genetic testing; and much more. - Uses an improved organization to enhance navigation. - Expert ConsultTM eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, Q&As, and references from the book on a variety of devices.
Vols. for 1963- include as pt. 2 of the Jan. issue: Medical subject headings.
As the field pediatric anesthesia advances and expands, so too does the gamut of challenges that are faced by today’s anesthesiologists. Gregory’s Pediatric Anesthesia aims to fully prepare trainees and experienced professionals for modern practice by equipping them with the knowledge and cutting-edge techniques necessary to safely and successfully anesthetize children for a range of different surgeries and other procedures. Supporting their work with current data and evidence, the authors explore topics including basic principles, potential complications, and best practice, and illustrate their findings with detailed case studies that cover all major subspecialties. This essential new edition includes access to illustrative videos and features new and expanded sections, such as: Anesthesia for Spinal Surgery complications including postoperative blindness Robotic surgery for Pediatric Urological Procedures Anesthesia for Non-Cardiac Surgery in Patients with Congenital Heart Disease (new chapter) Extensive additional ultrasound images for regional anesthesia Neonatal Resuscitation The Pediatric Surgical Home and Enhanced Recovery after Surgery (new chapter) Now in its sixth edition, Gregory’s Pediatric Anesthesia continues to provide reliable and easy-to-follow guidance to all anesthesiologists caring for younger patients.
Updated to reflect the newest curriculum standards, Textbook of Diagnostic Sonography, 8th Edition provides you with the pertinent information needed for passing the boards. This highly respected text enhances your understanding of general/abdominal and obstetric/gynecologic sonography, the two primary divisions of sonography, as well as vascular sonography and echocardiography. Each chapter covers patient history; normal anatomy, including cross-sectional anatomy; sonography techniques; pathology; and related laboratory findings. And more than 3,100 images and anatomy drawings guide you in recognizing normal anatomy and abnormal pathology. - Full-color presentation, including color scans of gross pathology photos, where appropriate, enhances your learning expe1rience and the teaching value of the text. - Pathology tables give you quick access to clinical findings, laboratory findings, sonography findings, and differential considerations. - Pedagogy, including chapter objectives and outlines, alerts you to the important information you will learn in each chapter. - Evolve site includes PowerPoint slides, an image bank, review questions and a workbook answer key for students, and a test bank for faculty to aid in the reinforcement and teaching of sonography skills. - Sonography Findings, highlighted with icon and special type, call attention to key clinical information. - NEW! Full coverage of general/abdominal, transplantation, superficial structures, pediatrics, fetal heart, and obstetric/gynecologic sonography, along with several new chapters on vascular sonography, hemodynamics, and introduction to echocardiography, provides you with the information needed to pass the boards and succeed in clinicals. - UPDATED! Content reflects the newest curriculum standards so you have the information you need to pass the boards. - NEW! Updated images depict the latest advances in the field of sonography and help you prepare for the boards and clinicals. - NEW! Key words in chapter openers focus your attention on the terms that you are required to know and understand. - NEW! Bulleted summary lists at the end of each chapter reinforce important concepts. - NEW! A condensed bibliography at the end of the book lists essential references and guides you in the direction to obtain more information in a given area.
In the highly specialized field of caring for children in the PICU, Fuhrman and Zimmerman's Pediatric Critical Care is the definitive reference for all members of the pediatric intensive care team. Drs. Jerry J. Zimmerman and Alexandre T. Rotta, along with an expert team of editors and contributors from around the world, have carefully updated the 6th Edition of this highly regarded text to bring you the most authoritative and useful information on today's pediatric critical care—everything from basic science to clinical applications. - Contains highly readable, concise chapters with hundreds of useful photos, diagrams, algorithms, and clinical pearls. - Uses a clear, logical, organ-system approach that allows you to focus on the development, function, and treatment of a wide range of disease entities. - Features more international authors and expanded coverage of global topics including pandemics, sepsis treatment in underserved communities, specific global health concerns by region. - Covers current trends in sepsis-related mortality and acute care after sepsis, as well as new device applications for pediatric patients. - Provides ultrasound videos and more than 500 board-style review questions and answers on Expert Consult. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Rev. ed. of: Pediatric anesthesia / [edited by] George A. Gregory. 4th ed. c2002.