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  • Chapter 41 - Principles of Paediatric Intensive Care

  • Edited by James Ip, Great Ormond Street Hospital for Children, London, Grant Stuart, Great Ormond Street Hospital for Children, London, Isabeau Walker, Great Ormond Street Hospital for Children, London, Ian James, Great Ormond Street Hospital for Children, London
  • Book:
    Core Topics in Paediatric Anaesthesia
    Published online:
    06 February 2025
    Print publication:
    13 February 2025, pp 467-479

  • Summary

    This chapter provides an outline of the areas of paediatric intensive care relevant to an anaesthetist. The chapter examines current epidemiology in critical care and the characteristics of children requiring transfer from local hospitals to specialist centres. It reviews differences between adult and paediatric respiratory physiology, outlines an approach to medications used in intubation and discusses respiratory support for critically unwell children. The chapter provides key basic guidance on the use of high-frequency oscillatory ventilation (HFOV) in children. Maintenance fluid and inotrope selection are also reviewed. The chapter also reviews presentations commonly encountered on paediatric intensive care units (PICU) across respiratory, cardiovascular, gastrointestinal, renal, neurological, metabolic and infectious conditions. Neuroprotection criteria are provided, with key relevance to anaesthetists who may need to undertake time-critical transfers from their usual place of work to neurosurgical centres. Organ donation and non-accidental injury are also discussed.