F U H R M A N Z I M M E R M A N ’ S & PEDIATRIC CRITICAL CARE SIXTH EDITION FUHRMAN & ZIMMERMAN’S PEDIATRIC CRITICAL CARE JERRY J. ZIMMERMAN, MD, PhD, FCCM ALEXANDRE T. ROTTA, MD, FCCM Faculty, Pediatric Critical Care Medicine, Seattle Children’s Division Chief, Pediatric Critical Care Medicine Duke Hospital, Harborview Medical Center, University of Children’s Hospital; Professor of Pediatrics; Duke University Washington School of Medicine, Seattle, Washington School of Medicine, Durham, North Carolina Robert S.B. Clark, MD Sapna Ravi Kudchadkar, MD, PhD, FCCM Professor and Vice Chair, Critical Care Medicine, University Associate Professor, Anesthesiology and Critical Care of Pittsburgh School of Medicine; Associate Director, Safar Medicine, Pediatrics, and Physical Medicine and Center for Resuscitation Research, University of Pittsburgh, Rehabilitation, Charlotte R. Bloomberg Children’s Center, Pittsburgh, Pennsylvania Johns Hopkins University School of Medicine, Baltimore, Maryland Bradley P. Fuhrman, MD, FAAP, MCCM Professor of Pediatrics in Medical Education, Monica Relvas, MD, FAAP, FCCM, MSHA Clinical Educator and Gold College Mentor, Paul L. Foster Medical Director, Pediatric Critical Care Medicine, School of Medicine, Texas Tech University HSC El Paso, Covenant Children’s Hospital, Associate Clinical Professor, El Paso, Texas Texas Tech University, Lubbock, Texas Joseph D. Tobias, MD Chair, Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital; Professor of Anesthesiology and Pediatrics, The Ohio State University, Columbus, Ohio Elsevier 1600 John F. Kennedy Blvd. Ste 1600 Philadelphia, PA 19103-2899 FUHRMAN AND ZIMMERMAN’S PEDIATRIC CRITICAL CARE, SIXTH EDITION ISBN: 978-0-323-67269-6 Copyright © 2022 by Elsevier, Inc. All rights reserved. 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Albert, MD Resident Physician Program Director, Critical Care Medicine Fellowship Department of Neurological Surgery Department of Anesthesiology, Critical Care, and Pain Medicine University of Washington Boston Children’s Hospital Seattle, Washington Boston, Massachusetts Jayani Abeysekera, MD, FRCP Alicia Alcamo, MD, MPH Assistant Professor Assistant Professor of Critical Care and Pediatrics Department of Pediatrics Department of Anesthesiology and Critical Care Medicine Division of Cardiology University of Pennsylvania Perelman School of Medicine Dalhousie University/IWK Health Centre Children’s Hospital of Philadelphia Halifax, Nova Scotia, Canada Philadelphia, Pennsylvania P. David Adelson, MD, FAAP, FACS, FAANS Matthew N. Alder, MD, PhD Diane and Bruce Halle Chair of Children’s Neurosciences Assistant Professor Director, Barrow Neurological Institute at Phoenix Children’s Critical Care Medicine Hospital Cincinnati Children’s Hospital Medical Center Professor, Department of Child Health Cincinnati, Ohio University of Arizona College of Medicine; Professor, Department of Neurosurgery Omar Alibrahim, MD, FAAP Mayo Clinic Chief, Pediatric Critical Care Division Phoenix, Arizona John R. Oishei Children’s Hospital Associate Professor of Pediatrics Rachel S. Agbeko, FRCPCH, PhD Jacob’s School of Medicine Consultant University of Buffalo Paediatric Intensive Care Unit Buffalo, New York Great North Children’s Hospital Newcastle upon Tyne Hospitals NHS Trust Veerajalandhar Allareddy, MBBS, MBA Newcastle upon Tyne, United Kingdom Section Chief, Pediatric Cardiac Intensive Care Duke University Medical Center Michael S.D. Agus, MD Professor of Pediatrics Chief of Medical Critical Care Duke University School of Medicine Department of Pediatrics Durham, North Carolina Division of Medical Critical Care Boston Children’s Hospital Melvin C. Almodovar, MD Boston, Massachusetts The George E. Batchelor Chair in Pediatric Cardiology Chief, Pediatric Cardiology Mubbasheer Ahmed, MD University of Miami Miller School of Medicine; Cardiac Intensive Care Unit Director, Children’s Heart Center Texas Medical Center Director, Cardiac Intensive Care Texas Children’s Hospital Hotz Children’s Hospital, Jackson Health System Houston, Texas Miami, Florida Alireza Akhondi-Asl, PhD Alexandra Aminoff, MD Departments of Anesthesiology, Critical Care, and Pain Acting Assistant Professor Medicine Department of Pediatric Rheumatology Division of Critical Care Seattle Children’s Hospital Boston Children’s Hospital Seattle, Washington Boston, Massachusetts v vi Contributors Catherine Amlie-Lefond, MD Adnan M. Bakar, MD Professor Assistant Professor of Pediatrics Department of Neurology Section Head, Pediatric Cardiac Critical Care University of Washington Cohen Children’s Medical Center of Hofstra/Northwell Seattle, Washington New Hyde Park, New York Rajesh Aneja, MD Katherine Banker, MD Clinical Chief, Division of Pediatric Critical Care Medicine Clinical Assistant Professor Medical Director, Pediatric Intensive Care Unit Department of Pediatrics, Critical Care Children’s Hospital of Pittsburgh of UPMC; Seattle Children’s Hospital Professor Seattle, Washington Department of Critical Care Medicine and Pediatrics University of Pittsburgh School of Medicine Piers C.A. Barker, MD Pittsburgh, Pennsylvania Professor of Pediatrics and Obstetrics/Gynecology Department of Pediatrics Abigail Apple, ARNP Duke University School of Medicine Pediatric Critical Care Durham, North Carolina Seattle Children’s Hospital Seattle, Washington Lee M. Bass, MD Associate Professor of Pediatrics Andrew C. Argent, MD Departments of Gastroenterology, Hepatology & Nutrition Professor Ann & Robert H. Lurie Children’s Hospital of Chicago School of Child and Adolescent Health Northwestern University Feinberg School of Medicine University of Cape Town; Chicago, Illinois Medical Director Paediatric Intensive Care Rajit K. Basu, MD, MS, FCCM Red Cross War Memorial Children’s Hospital Associate Professor of Pediatrics Cape Town, South Africa Emory School of Medicine; Research Director Joan C. Arvedson, PhD Division of Pediatric Critical Care Medicine Program Coordinator, Feeding & Swallowing Services Children’s Healthcare of Atlanta Speech Pathology and Audiology Atlanta, Georgia Children’s Hospital of Wisconsin; Clinical Professor Hülya Bayir, MD Department of Pediatrics Safar Center for Resuscitation Research Medical College of Wisconsin Department of Critical Care Medicine Milwaukee, Wisconsin University of Pittsburgh School of Medicine Children’s Hospital of Pittsburgh of UPMC François Aspesberro, MD Pittsburgh, Pennsylvania Pediatric Cardiothoracic ICU Miller Children’s & Women’s Hospital Long Beach Lance B. Becker, MD Long Beach, California Chair, Emergency Medicine Donald and Barbara Zucker School of Medicine at Nir Atlas, MD Hofstra/Northwell Clinical Fellow Hempstead, New York Division of Pediatric Critical Care Children’s Healthcare of Atlanta–Egleston Jamie L. Bell, MD Emory University School of Medicine Assistant Professor of Pediatrics Atlanta, Georgia Department of Pediatrics Children’s Hospital of Michigan John E. Baatz, PhD Wayne State University School of Medicine Professor Detroit, Michigan Department of Pediatrics Medical University of South Carolina Michael J. Bell, MD Charleston, South Carolina Chief, Pediatric Critical Care Medicine Department of Pediatrics Harris P. Baden, MD Children’s National Medical Center Professor and Chief Washington, DC Pediatric Cardiac Critical Care University of Washington Seattle Children’s Hospital Seattle, Washington Contributors vii Melania M. Bembea, MD, MPH, PhD Naomi B. Bishop, MD Associate Professor Assistant Professor Department of Anesthesiology and Critical Care Medicine Department of Pediatric Critical Care Medicine Johns Hopkins University School of Medicine Weill Cornell Medical College Baltimore, Maryland New York, New York M.A. Bender, MD, PhD Julie Blatt, MD Director, Sickle Cell and Hemoglobinopathy Program Professor Odessa Brown Children’s Clinic; Pediatric Hematology Oncology Associate Professor University of North Carolina Department of Pediatrics Chapel Hill, North Carolina University of Washington Seattle, Washington Lauren Bodilly, MD Critical Care Fellow Alexis L. Benscoter, DO Department of Pediatric Critical Care Assistant Professor of Clinical Pediatrics Cincinnati Children’s Hospital University of Cincinnati College of Medicine; Cincinnati, Ohio Department of Cardiac Critical Care Medicine Division of Cardiology Robert H. Bonow, MD Cincinnati Children’s Hospital Medical Center Resident Physician Cincinnati, Ohio Department of Neurological Surgery University of Washington Wade W. Benton, PharmD Seattle, Washington Chief Development Officer Eicos Sciences, Inc. E. Alexis Bragg, MD San Mateo, California Assistant Professor of Anesthesiology and Pediatrics Department of Anesthesia and Critical Care Medicine Robert A. Berg, MD Children’s Hospital Los Angeles Professor Keck School of Medicine–University of Southern California Departments of Anesthesiology, Critical Care Medicine, Los Angeles, California and Pediatrics University of Pennsylvania Perelman School of Medicine; Barbara W. Brandom, MD Division Chief, Critical Care Medicine Retired Professor Departments of Anesthesiology and Critical Care Medicine Department of Anesthesiology Children’s Hospital of Philadelphia University of Pittsburgh; Philadelphia, Pennsylvania Retired Director North American MH Registry of MHAUS Emily Berkman, MD Pittsburgh, Pennsylvania Assistant Professor Departments of Pediatrics and Bioethics and Humanities Richard J. Brilli, MD University of Washington School of Medicine; Chief Medical Officer Division of Pediatric Critical Care Hospital Administration Department of Pediatric Bioethics Nationwide Children’s Hospital; Treuman Katz Center for Pediatric Bioethics Professor Seattle Children’s Hospital Department of Pediatrics Seattle, Washington Division of Critical Care Medicine The Ohio State University College of Medicine Carol Berkowitz, MD Columbus, Ohio Chief, Division of General Pediatrics Department of Pediatrics Thomas V. Brogan, MD Harbor-UCLA Medical Center Professor Torrance, California; Department of Pediatrics Distinguished Professor of Pediatrics University of Washington School of Medicine David Geffen School of Medicine at UCLA Seattle, Washington Los Angeles, California Ronald A. Bronicki, MD, FCCM, FACC Katherine V. Biagas, MD Professor Associate Professor Departments of Critical Care Medicine and Cardiology Department of Pediatrics Texas Children’s Hospital and Baylor College of Medicine Vice Chairman for Faculty Development Houston, Texas Stony Brook Children’s and the Renaissance School of Medicine Stony Brook, New York viii Contributors Samuel R. Browd, MD, PhD, FAANS, FAAP Michael P. Carboni, MD Professor Medical Director, Pediatric Heart Failure & Transplant Department of Neurological Surgery Department of Pediatrics Seattle Children’s Hospital Duke Children’s Hospital University of Washington Durham, North Carolina Seattle, Washington Joseph A. Carcillo, MD Timothy E. Bunchman, MD Professor of Critical Care Medicine and Pediatrics Professor and Director, Pediatric Nephrology Children’s Hospital of Pittsburgh Children’s Hospital of Richmond University of Pittsburgh School of Medicine Virginia Commonwealth University School of Medicine Pittsburgh, Pennsylvania Richmond, Virginia Antonio Cassara, MBChB Jeffrey P. Burns, MD, MPH Associate Professor Chief and Endowed Shapiro Chair of Critical Care Medicine Department of Anesthesia Chair, Governance Committee of the Intensive Care Units Ruby Memorial Hospital Boston Children’s Hospital Morgantown, West Virginia Professor of Anesthesia Harvard Medical School Nina Censoplano, MD Boston, Massachusetts Attending physician Pediatric Critical Care Medicine David F. Butler, MD INOVA Fairfax Medical Center Fellow Falls Church, Virginia Department of Pediatrics Division of Critical Care Victoria Chadwick, PharmD, BCCCP Seattle Children’s Hospital Critical Care Pharmacist Seattle, Washington Seattle Children’s Hospital Seattle, Washington Derya Caglar, MD Fellowship Director, Pediatric Emergency Medicine Reid C. Chamberlain, MD Associate Professor, Pediatrics Pediatric Cardiology Fellow University of Washington School of Medicine Department of Pediatrics Attending Physician Duke University Hospital Division of Pediatric Emergency Medicine Durham, North Carolina Seattle Children’s Hospital Seattle, Washington Anny Chan, PharmD Hematopoietic Stem Cell Transplant Clinical Pharmacist Michael W. Camitta, MD Seattle Children’s Hospital Associate Professor of Pediatrics Seattle, Washington Department of Pediatrics Duke University School of Medicine John R. Charpie, MD, PhD Durham, North Carolina Amnon Rosenthal Professor & Director of Pediatric Cardiology University of Michigan Medical School M. Jay Campbell, MD, MHA Co-Director, University of Michigan Congenital Heart Center Associate Professor of Pediatrics C.S. Mott Children’s Hospital Department of Pediatrics Michigan Medicine Duke University School of Medicine Ann Arbor, Michigan Durham, North Carolina Ira M. Cheifetz, MD Sally Campbell, MBBS(Hons), FRACP, FRCPA Professor Paediatric Haematologist Departments of Pediatrics and Anesthesiology Royal Children’s Hospital Duke University Medical Center Melbourne, Australia Durham, North Carolina Karel D. Capek, MD Saurabh Chiwane, MD Fellow Assistant Professor Acute Burn, Critical Care, and Reconstruction Department of Pediatrics Shriners Hospitals for Children Saint Louis University Galveston and the University of Texas Medical Branch St. Louis, Missouri Galveston, Texas