Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Introduction
- Differences
- Clinical Assessment
- Introduction
- Scoring Systems and Quality Metrics in PICU
- Paediatric Intensive Care Transport Services
- Changing Patterns of PICU
- Relevance to the Intensivist
- How Widespread Is Child Abuse?
- Types of Abuse
- The Safeguarding Process – Roles, Responsibilities and Processes
- Respiratory Anatomy and Physiology in Children
- Upper Airway Obstruction
- Intubating the Child with Upper Airway Obstruction
- Paediatric Acute Respiratory Distress Syndrome
- Diseases of the Lower Airway
- High-Flow Nasal Cannulae
- Continuous Positive Airway Pressure
- Mechanical Ventilation
- High-Frequency Oscillatory Ventilation
- Extracorporeal Membrane Oxygenation
- Definition and Recognition of Sepsis
- Patterns of Sepsis Presentation
- Haemodynamics of Paediatric Septic Shock
- Protocolised Management of Sepsis
- Current Controversies
- Outcomes in Sepsis and Septic Shock
- Introduction
- Status Epilepticus
- Coma
- Neurosurgical Emergencies
- Introduction
- Initial Management
- Sudden Unexpected Death in Infancy and Sudden Infant Death Syndrome
- Introduction
- Presentation in Infancy
- Diagnosis and Management of Infants with Suspected Congenital Heart Disease
- Norwood Stage 1, Glenn or Fontan
- Acute Presentations
- Introduction
- The Primary Survey
- Head Injury
- Cervical Spine Injury
- Introduction
- Acute Liver Failure
- Inborn Errors of Metabolism
- Diabetic Ketoacidosis
- Introduction
- Analgesic Agents
- Sedative Agents
- 9.1 Assessment and Management of the Sick Child
- 9.2 Organisation of Paediatric Intensive Care and Paediatric Intensive Care Transport Services in the UK
- 9.3 Safeguarding and Non-accidental Injury
- 9.4 Respiratory Failure
- 9.5 Paediatric Sepsis
- 9.6 Acute Neurological Disorders
- 9.7 The Collapsed Infant
- 9.8 Congenital Heart Disease
- 9.9 Trauma
- 9.10 Acute Liver Failure, Inborn Errors of Metabolism and Diabetic Ketoacidosis
- 9.11 Analgesia and Sedation in the Paediatric Intensive Care Unit
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
9.10 - Acute Liver Failure, Inborn Errors of Metabolism and Diabetic Ketoacidosis
from Section 9 - Paediatric Care
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Introduction
- Differences
- Clinical Assessment
- Introduction
- Scoring Systems and Quality Metrics in PICU
- Paediatric Intensive Care Transport Services
- Changing Patterns of PICU
- Relevance to the Intensivist
- How Widespread Is Child Abuse?
- Types of Abuse
- The Safeguarding Process – Roles, Responsibilities and Processes
- Respiratory Anatomy and Physiology in Children
- Upper Airway Obstruction
- Intubating the Child with Upper Airway Obstruction
- Paediatric Acute Respiratory Distress Syndrome
- Diseases of the Lower Airway
- High-Flow Nasal Cannulae
- Continuous Positive Airway Pressure
- Mechanical Ventilation
- High-Frequency Oscillatory Ventilation
- Extracorporeal Membrane Oxygenation
- Definition and Recognition of Sepsis
- Patterns of Sepsis Presentation
- Haemodynamics of Paediatric Septic Shock
- Protocolised Management of Sepsis
- Current Controversies
- Outcomes in Sepsis and Septic Shock
- Introduction
- Status Epilepticus
- Coma
- Neurosurgical Emergencies
- Introduction
- Initial Management
- Sudden Unexpected Death in Infancy and Sudden Infant Death Syndrome
- Introduction
- Presentation in Infancy
- Diagnosis and Management of Infants with Suspected Congenital Heart Disease
- Norwood Stage 1, Glenn or Fontan
- Acute Presentations
- Introduction
- The Primary Survey
- Head Injury
- Cervical Spine Injury
- Introduction
- Acute Liver Failure
- Inborn Errors of Metabolism
- Diabetic Ketoacidosis
- Introduction
- Analgesic Agents
- Sedative Agents
- 9.1 Assessment and Management of the Sick Child
- 9.2 Organisation of Paediatric Intensive Care and Paediatric Intensive Care Transport Services in the UK
- 9.3 Safeguarding and Non-accidental Injury
- 9.4 Respiratory Failure
- 9.5 Paediatric Sepsis
- 9.6 Acute Neurological Disorders
- 9.7 The Collapsed Infant
- 9.8 Congenital Heart Disease
- 9.9 Trauma
- 9.10 Acute Liver Failure, Inborn Errors of Metabolism and Diabetic Ketoacidosis
- 9.11 Analgesia and Sedation in the Paediatric Intensive Care Unit
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Children with acute liver failure (ALF) require rapid stabilisation and should be moved to a specialist centre as quickly as possible.
2. Once on a paediatric intensive care unit, ALF patients undergo standard neurocritical intensive care and a transplant assessment.
3. In ALF, children with encephalopathy more severe than grade 1 should be considered for intubation.
4. The mean arterial pressures targeted for encephalopathic patients vary with age.
5. In diabetic ketoacidosis, cerebral oedema is the most common cause of mortality and neurological observations should be performed regularly.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 722 - 725Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
British Inherited Metabolic Diseases Group (BIMDG). Emergency guidelines. bimdg.org.uk/site/guidelines.aspGoogle Scholar
British Society for Paediatric Endocrinology and Diabetes. Guidelines. www.bsped.org.uk/clinical-resources/guidelines/Google Scholar
British Society for Paediatric Endocrinology and Diabetes. BSPED interim guideline for the management of children and young people under the age of 18 years with diabetic ketoacidosis. www.bsped.org.uk/clinical/docs/DKAGuideline.pdfGoogle Scholar
Champion, M. An approach to the diagnosis of inherited metabolic disease. Arch Dis Child Educ Pract 2010;95:40–6.Google Scholar
Conn, HO. Quantifying the severity of hepatic encephalopathy. In: Conn, HO, Bircher, J (eds). Hepatic Encephalopathy: Syndromes and Therapies. Bloomington, IL: Medi-ed Press; 1994. pp. 13–26.Google Scholar
Durand, P, Debray, D, Mandel, R, et al. Acute liver failure in infancy: a 14-year experience of a pediatric liver transplantation center. J Pediatr 2001;139:871–6.Google Scholar
Kuppermann, N, Ghetti, S, Schunk, JE, et al. Clinical trial of fluid infusion rates for pediatric diabetic ketoacidosis. N Engl J Med 2018;378:2275–87.Google Scholar
Lee, WM, Stravitz, RT, Larson, AM. Introduction to the revised American Association for the Study of Liver Diseases Position Paper on acute liver failure 2011. Hepatology 2012;55:965–7.CrossRefGoogle Scholar
Squires, RH Jr, Shneider, BL, Bucuvalas, J, et al. Acute liver failure in children: the first 348 patients in the pediatric acute liver failure study group. J Pediatr 2006;148:652–8.CrossRefGoogle ScholarPubMed
Wolfdorsf, JI. The International Society of Pediatric and Adolescent Diabetes guidelines for management of diabetic ketoacidosis: do the guidelines need to be modified? Pediatr Diabetes 2014:15:277–86.Google Scholar