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The Neonatal Resuscitation Program (NRP) is an educational program jointly sponsored by the American Academy of Pediatrics (AAP) and the American Heart Association (AHA). This updated edition reflects the 2015 AAP/AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care of the Neonate. Full color.
This book provides a concise yet comprehensive overview of pediatric acute respiratory distress syndrome (PARDS). The text reviews the emerging science behind the new PARDS definition; explores epidemiology, pathobiology, etiologies, and risk factors; reviews state-of-the-art treatment modalities and strategies; and discusses clinical outcomes. Written by experts in the field, Pediatric Acute Respiratory Distress Syndrome: A Clinical Guide is a valuable resource for clinicians and practitioners who specialize in pediatric critical care.
Pediatric Resuscitation is reviewed in this issue of Pediatric Clinics of North America, guest edited by Drs. Steve Schexnayder and Arno Zaritsky. Authorities in the field have come together to pen articles on Background and Epidemiology; CPR - Why the New Emphasis?; Airway Management; Arrthymias, Cardioversion, and Defibrillation; Vascular Access and Medications; Medical Emergency Teams; Teamwork in Resuscitation; Resuscitation Education; Outcome Following Cardiac Arrest; Extracorporeal Life Support during CPR; Post-resuscitation Care; and Future Directions.
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 definitive manual of pediatric medicine - completely updated with 75 new chapters and e-book access.
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.
This book covers all of the important elements of paediatric anaesthesia in a concise and structured manner. From the premature infant to the teenager, readers are guided through the complexities they may encounter, with key points at the end of each chapter to summarise the most important information. The common surgical conditions encountered in daily practice are covered along with comprehensive discussion of consent and the law, safeguarding children, and the complexity of drug dosing in the paediatric population. Other topics covered include trauma, burns, resuscitation, principles of intensive care, and transporting a sick child. Each chapter is written by an acknowledged expert in their field, sharing a wealth of relevant, practical experience. Covering the whole curriculum necessary for advanced training, this is essential reading for trainees, general anaesthetists managing children in non-specialist hospitals and anyone aspiring to become a paediatric anaesthetist, as well as those established in the field.
An in-depth review by leading authorities of the latest therapies and techniques for rescuing persons in cardiac arrest. The authors explore the physiology behind current state-of-the-art clinical resuscitation and translate it into practical bedside recommendations, clinical tips, and expert techniques. Topics of interest include the epidemiology of sudden death, management of ventilation, chest compression technique training, public access defibrillation, drug delivery during CPR, the latest drug therapies, and cardiac arrest in disease, pregnancy, drowning, lightning strike, and trauma. The authors also review the major ongoing research in resuscitation science that will likely affect the next set of international resuscitation guidelines.