TAILIEUCHUNG - Ebook Pediatric critical care medicine: Part 2

(BQ) Part 2 book "Pediatric critical care medicine" presents the following contents: Endocrine disorders, disorders of host defense, hematologic and oncologic disorders, cardiac diseases, respiratory disorders, neurologic disorders, gastrointestinal disorders, renal disorders. | II Clinical Disorders A Endocrine Disorders Murray M. Pollack Paul Kaplowitz 11 Endocrine Disorders of Water Regulation Susan B. Nunez CLINICAL SYNDROMES OF ABNORMAL WATER REGULATION Manifestations of derangements in osmotic homeostasis are due to alterations in cell volume in the central nervous system CNS changes in effective circulating volume and local disturbances produced that is by an intracranial neoplasm. In the steady state the net water balance should be zero. Hypertonicity occurs when the renal plus extrarenal water losses exceed water intake causing the ratio of solutes to water in the body fluids to increase. In hypotonic syndromes water intake exceeds the sum of renal plus extrarenal water losses but in chronic hyponatremia water intake and water output may be equal. HYPONATREMIA Hyponatremia defined as a serum sodium level 135 mEq per L is a common electrolyte imbalance in the setting of pediatric critical care. It can occur in children who are volume contracted and have lost sodium in excess of water as in severe diarrhea or renal sodium losses due to adrenal insufficiency with inadequate aldosterone production. This is particularly challenging in patients with acute CNS disease especially if the sodium is low 125 mEq per L which can cause seizures and worsen neurologic status. The differential diagnosis is often between the syndrome of inappropriate secretion of antidiuretic hormone SIADH and the cerebral salt wasting CSW syndrome. Distinguishing between the two causes is important because the treatment of each condition is very different. In both there is hyponatremia and inappropriately concentrated urine. SIADH is associated with increased extracellular fluid volume ECF . In CSW syndrome there is clinical evidence of a contracted ECF volume. SYNDROME OF INAPPROPRIATE SECRETION OF ANTIDIURETIC HORMONE This syndrome although common in the pediatric critical care setting is rarely the reason for admission to the pediatric intensive care unit PICU

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• Pediatric critical care medicine
• Endocrine disorders
• Disorders of host defense
• Hematologic and oncologic disorders
• Cardiac diseases
• Respiratory disorders
• Neurologic disorders
• Care of the critically ill or injured child
• The practice of pediatric critical care medicine
• The science of pediatric critical care medicine
• Palliative care in the PICU
• Controversies and considerations
• Toxic ingestions
• Heat illness and hypothermia
• Pediatric drowning
• Pandemic influenza
• Peri operative care
• Anesthesia in the critically ill child
• Pharmacology of inhalational
• Intravenous anesthetic agents
• Sedation and analgesia
• Pediatric lung transplantation
• The gastrointestinal system
• The endocrine system
• The renal system
• Critical illness
• Critical illness and injury
• The hematologic system
• Oncologic disorders
• The immune system
• Cardiac surgery
• The solid organ transplant patient
• General Post operative management
• BMC Pediatrics
• Fellow education
• Transport medicine
• Neonatal Perinatal medicine
• Pediatric emergency medicine
• Cardiac physiology
• Shock and shock syndromes
• Shock syndromes
• Defense mechanisms of the pulmonary tree
• Physiology and pathophysiology
• Central nervous systems
• Applied respiratory physiology
• The upper respiratory tract
• Mechanical ventilation
• Status asthmaticus
• The cardiovascular system
• The central nervous system
• Movement disorders in the ICU
• Status epilepticus
• Toxic metabolic encephalopathy
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