I Fourth Edition Pediatric Critical Care Bradley P. Fuhrman, MD, FCCM Monica Relvas, MD, FAAP Professor of Pediatrics and Anesthesiology Pediatric Critical Care Medicine University at Buffalo School of Medicine Followship Director Chief, Pediatric Critical Care Medicine Virginia Commonwealth University Women and Children’s Hospital of Buffalo Richmond, Virginia Buffalo, New York Alexandre T. Rotta, MD, FCCM, FAAP Director, Pediatric Cardiac Critical Care Program Jerry J. Zimmerman, MD, Riley Hospital for Children, Indiana University PhD, FCCM Associate Professor of Clinical Pediatrics Professor of Pediatrics and Anesthesiology Indiana University School of Medicine Director, Pediatric Critical Care Medicine Indianapolis, Indiana Seattle Children’s Hospital Seattle, Washington Ann E. Thompson, MD, MHCPM Professor and Vice Chair for Faculty Development Joseph A. Carcillo, MD Department of Critical Care Medicine Associate Professor of Critical Care Medicine Associate Dean for Faculty Affairs and Pediarics University of Pittsburgh School of Medicine Children’s Hospital of Pittsburgh of UPMC Medical Director for Clinical Resource University of Pittsburgh School of Medicine Management Pittsburgh, Pennsylvania Children’s Hospital of Pittsburgh Pittsburgh, Pennsylvania Robert S.B. Clark, MD Chief, Division of Pediatric Critical Care Joseph D. Tobias, MD Medicine Chief, Department of Anesthesiology & Children’s Hospital of Pittsburgh of UPMC Pain Medicine Associate Director, Safar Center for Nationwide Children’s Hospital Resuscitation Research Professor of Anesthesiology & Pediatrics University of Pittsburgh Ohio State University Pittsburgh, Pennsylvania Columbus, Ohio 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 PEDIATRIC CRITICAL CARE, ed 4 ISBN: 978-0-323-07307-3 Copyright © 2011, 2006, 1998, 1992 by Mosby, Inc., an affiliate of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data: 978-0-323-07307-3 Executive Publisher: Natasha Andjelkovic Developmental Editor: Julia Bartz Publishing Services Manager: Patricia Tannian Project Manager: Carrie Stetz Design Direction: Ellen Zanolle Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 Contributors Veda L. Ackerman, MD Derek C. Angus, MD, MPH, FRCP Associate Professor of Pediatrics Chair, Department of Critical Care Medicine Indiana University School of Medicine; The Mitchell P. Fink Endowed Chair in Critical Care Associate Medical Director Medicine Pediatric Intensive Care Unit Professor of Critical Care Medicine, Medicine, Health Policy Riley Hospital for Children and Management, and Clinical and Translational Science Indianapolis, Indiana University of Pittsburgh School of Medicine and Graduate School of Public Health P. David Adelson, MD, FACS, FAAP Pittsburgh, Pennsylvania Director, Children’s Neuroscience Institute; Division Chief of Pediatric Neurosurgery Andrew C. Argent, MBBCh(Wits), MMed(Paeds)(Wits), Phoenix Children’s Hospital; DCH(SA), FCPaeds(SA), FRCPCH(UK) Clinical Professor of Neurosurgery and Child Health Professor, School of Child and Adolescent Health University of Arizona College of Medicine Phoenix; University of Cape Town; Adjunct Professor Medical Director School of Biological and Health Systems Engineering Paediatric Intensive Care Ira A. Fulton School of Engineering Red Cross War Memorial Children’s Hospital Arizona State University Cape Town, Western Cape, South Africa Phoenix, Arizona Francois P. Aspesberro, MD Rachel S. Agbeko, MD, FRCPCH Attending Physician Affiliate Senior Clinical Lecturer Seattle Children’s Hospital; Department of Paediatric Intensive Care Assistant Professor of Pediatrics Great North Children’s Hospital University of Washington School of Medicine Royal Victoria Infirmary Seattle, Washington Newcastle upon Tyne, Great Britain Adnan M. Bakar, MD Melvin C. Almodovar, MD Fellow, Pediatric Critical Care Medicine Associate in Cardiology Children’s Hospital of New York Medical Director, Cardiac ICU Columbia University College of Physicians and Surgeons Division of Cardiovascular Critical Care New York, New York Department of Cardiology Children’s Hospital Boston; Barbara Bambach, MD Assistant Professor of Pediatrics Associate Professor Harvard Medical School Department of Pediatrics Boston, Massachusetts State University of New York at Buffalo Roswell Park Cancer Institute Estella M. Alonso, MD Buffalo, New York Pediatric Hepatology Children’s Memorial Hospital; Lee M. Bass, MD Professor of Pediatrics Assistant Professor of Pediatrics Northwestern University Feinberg School of Medicine Northwestern University Feinberg School of Medicine; Chicago, Illinois Division of Gastroenterology, Hepatology and Nutrition Children’s Memorial Hospital Raj K. Aneja, MD Chicago, Illinois Assistant Professor Departments of Critical Care Medicine and Pediatrics University of Pittsburgh Medical Director, Pediatric Intensive Care Unit Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania v vi Contributors Hülya Bayir, MD Darryl H. Berkowitz, MBBCh Associate Professor Assistant Professor of Anesthesia Department of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Department of Environmental and Occupational Health University of Pennsylvania School of Medicine; Director, Pediatric Critical Care Medicine Research Attending Anesthesiologist Associate Director, Center for Free Radical and Antioxidant The Children’s Hospital of Philadelphia Health Philadelphia, Pennsylvania Safar Center for Resuscitation Research University of Pittsburgh Omar J. Bhutta, MD Pittsburgh, Pennsylvania Fellow Pediatric Critical Care Medicine Pierre Beaulieu, MD, PhD, FRCA Seattle Children’s Hospital Associate Professor University of Washington School of Medicine Department of Pharmacology & Anesthesiology Seattle, Washington Faculty of Medicine–University of Montreal Montreal, Quebec, Canada Katherine C. Biagas, MD, FAAP, FCCM Associate Professor of Clinical Pediatrics Michael J. Bell, MD Interim Director, Pediatric Critical Care Medicine Associate Professor of Critical Care Medicine, Neurological Director, Pediatric Critical Care Medicine Fellowship Surgery and Pediatrics Columbia University College of Physicians and Surgeons Director, Pediatric Neurocritical Care New York, New York Director, Pediatric Neurotrauma Center Associate Director, Safar Center for Resuscitation Research Julie Blatt, MD University of Pittsburgh Professor of Pediatrics Pittsburgh, Pennsylvania Pediatric Hematology Oncology University of North Carolina M.A. Bender, MD, PhD Chapel Hill, North Carolina Associate Professor Department of Pediatrics Douglas L. Blowey, MD University of Washington; Associate Professor of Pediatrics and Pharmacology Director, Odessa Brown Children’s Clinic Hemoglobinopathy University of Missouri–Kansas City Program Children’s Mercy Hospitals and Clinics Seattle, Washington Kansas City, Missouri Jeffrey C. Benson, MD Jeffrey L. Blumer, MD, PhD Assistant Professor Professor of Pediatrics and Pharmacology Department of Pediatrics Case Western Reserve University Section of Critical Care Medicine School of Medicine Section of Pulmonary Medicine Cleveland, Ohio Medical College of Wisconsin; Assistant Medical Director John S. Bradley, MD Pediatric Intensive Care Unit Director, Division of Infectious Diseases Children’s Hospital of Wisconsin Rady Children’s Hospital Milwaukee, Wisconsin Associate Clinical Professor University of California San Diego Wade W. Benton, PharmD San Diego, California Associate Director, Medical Affairs Actelion Pharmaceuticals US Barbara W. Brandom, MD South San Francisco, California Professor Department of Anesthesiology Robert A. Berg, MD University of Pittsburgh School of Medicine; Professor of Anesthesiology, Critical Care Medicine, and Director, North American MH Registry of the Malignant Pediatrics Hyperthermia Association of the United States University of Pennsylvania School of Medicine; Mercy Hospital UPMC Division Chief, Critical Care Medicine Pittsburgh, Pennsylvania Russell Raphaely Endowed Chair of Critical Care Medicine The Children’s Hospital of Philadelphia Linda Brodsky, MD Philadelphia, Pennsylvania Professor of Otolaryngology and Pediatrics (Retired) State University of New York at Buffalo; President, Pediatric ENT Associates Buffalo, New York Contributors vii Thomas V. Brogan, MD Joseph A. Carcillo, MD Associate Professor Associate Professor of Critical Care Medicine and Pediatrics Department of Pediatrics Children’s Hospital of Pittsburgh of UPMC University of Washington School of Medicine; University of Pittsburgh School of Medicine Seattle Children’s Hospital Pittsburgh, Pennsylvania Seattle, Washington Hector Carrillo-Lopez, MD Adam W. Brothers, PharmD Professor of Pediatric Critical Care Bone Marrow Transplant Clinical Pharmacist Pediatric Intensive Care Department Seattle Children’s Hospital Hospital Infantil de Mexico Federico Gomez Seattle, Washington Mexico City, Mexico Timothy E. Bunchman, MD Antonio Cassara, MD Professor of Pediatric Nephrology Visiting Assistant Professor Pediatric Continuous Renal Replacement Therapy Department of Anesthesiology Foundation Children’s Hospital of Pittsburgh Grand Rapids, Michigan Pittsburgh, Pennsylvania Randall S. Burd, MD, PhD Michael G. Caty, MD, MMM Chief, Division of Trauma and Burns John E. Fisher Professor of Pediatric Surgery Children’s National Medical Center Department of Pediatric Surgical Services Washington, DC Surgeon-in-Chief Women & Children’s Hospital of Buffalo; Jeffrey Burns, MD, MPH Professor of Surgery and Pediatrics Chief Chief, Division of Pediatric Surgery Division of Critical Care Medicine Department of Surgery Children’s Hospital Boston; State University of New York at Buffalo Associate Professor of Anaesthesia Buffalo, New York Harvard Medical School Boston, Massachusetts John R. Charpie, MD, PhD Professor and Division Director Sean P. Bush, MD Pediatric Cardiology Department of Pediatrics & Professor of Emergency Medicine Communicable Diseases Director, Fellowship of Envenomation Medicine C.S. Mott Children’s Hospital Department of Emergency Medicine University of Michigan Loma Linda University School of Medicine Ann Arbor, Michigan Medical Center & Children’s Hospital Loma Linda, California Adrian Chavez, MD Director, Pediatric Intensive Care Louis L. Bystrak, PharmD, BCPS Hospital Infantil de Mexico Federico Gomez; Clinical/Staff Pharmacist Assistant Professor of Pediatric Critical Care & Pediatrics Women & Children’s Hospital of Buffalo-Kaleida Health; Facultad de Medicina Adjunct Instructor, Department of Pharmacy Universidad Nacional Autonoma de Mexico The University at Buffalo School of Pharmacy and Pharma- Mexico City, Mexico ceutical Sciences Buffalo, New York John C. Christenson, MD Professor of Clinical Pediatrics Angela J.P. Campbell, MD, MPH Director, Ryan White Center for Pediatric Infectious Disease Assistant Professor Director, Pediatric Travel Medicine Clinic Pediatric Infectious Diseases Director, Pediatric Infectious Disease Fellowship Program University of Washington Indiana University School of Medicine Seattle Children’s Hospital Riley Hospital for Children Seattle, Washington Indianapolis, Indiana Christopher R. Cannavino, MD Jonna D. Clark, MD Divisions of Infectious Diseases & Hospital Medicine Pediatric Critical Care Fellow Rady Children’s Hospital; Pediatric Critical Care Medicine Assistant Clinical Professor of Pediatrics Seattle Children’s Hospital University of California at San Diego; Seattle, Washington Director, Pediatrics Clerkship University of California San Diego School of Medicine San Diego, California viii Contributors Robert S.B. Clark, MD Martha A.Q. Curley, RN, PhD, FAAN Chief, Division of Pediatric Critical Care Medicine Professor and Killebrew-Censits Term Chair Children’s Hospital of Pittsburgh of UPMC School of Nursing Associate Director, Safar Center for Resuscitation Research Anesthesia and Critical Care Medicine University of Pittsburgh University of Pennsylvania Pittsburgh, Pennsylvania Philadelphia, Pennsylvania; Nurse Scientist Katherine C. Clement, MD Cardiovascular and Critical Care Program Assistant Professor Children’s Hospital Boston Department of Anesthesiology Boston, Massachusetts Division of Pediatric Critical Care Medicine University of North Carolina at Chapel Hill Marek Czosnyka, MD Chapel Hill, North Carolina Department of Neurosurgery Cambridge University Jacqueline J. Coalson, PhD Cambridge, England Department of Pathology University of Texas Health Science Center–San Antonio Christopher A. D’Angelis, MD, PhD San Antonio, Texas Department of Pathology State University of New York at Buffalo School of Medicine Craig M. Coopersmith, MD, FACS, FCCM and Biomedical Sciences Professor of Surgery Buffalo, New York Director, 5E Surgical Intensive Care Unit Associate Director, Emory Center for Critical Care Mary K. Dahmer, PhD Emory University School of Medicine Associate Professor of Pediatric Critical Care Atlanta, Georgia Department of Pediatrics Medical College of Wisconsin Christopher P. Coppola, MD, MBA Milwaukee, Wisconsin Associate Pediatric Surgery Janet Weis Children’s Hospital Heidi J. Dalton, MD Danville, Pennsylvania Chief, Critical Care Medicine Phoenix Children’s Hospital; Seth J. Corey, MD, MPH Director, Pediatric/Cardiac ECMO Sharon Murphy-Steven Rosen Research Professor Phoenix Children’s Hospital Department of Pediatrics and Cellular & Molecular Biology Phoenix, Arizona Children’s Memorial Hospital & Robert H. Lurie Cancer Center Stéphane Dauger, Prof Northwestern University Feinberg School of Medicine Service de Réanimation et de Surveillance Continue Chicago, Illinois Pédiatriques Pôle de Pédiatrie Aiguë et de Médecine Interne de l’Enfant Peter N. Cox, MBChB, DCH, FFARCS(UK), FRCP(C) Hôpital Robert Debré Associate Chief Paris, France; Clinical Director, Paediatric Intensive Care Unit Assistance Publique Fellowship Program Director Hôpitaux de Paris et Université Paris Department of Critical Care Medicine Colombes, France Hospital for Sick Children; Professor, Anaesthesia, Critical Care and Paediatrics Peter J. Davis, MD, FAAP University of Toronto Anesthesiologist-in-Chief Toronto, Canada Children’s Hospital of Pittsburgh of UPMC; Professor of Anesthesiology & Pediatrics James J. Cummings, MD University of Pittsburgh School of Medicine Professor of Pediatrics and Physiology Pittsburgh, Pennsylvania East Carolina University Brody School of Medicine Section Head Scottie B. Day, MD Neonatal-Perinatal Medicine Critical Care Medicine University Health Systems of Eastern Carolina Cincinnati Children’s Hospital Medical Center Greenville, North Carolina Cincinnati, Ohio M. Theresa de la Morena, MD Associate Professor of Pediatrics and Internal Medicine University of Texas Southwestern Medical Center Dallas Dallas, Texas Contributors ix Cláudio Flauzino de Oliveira, MD, PhD Howard Eigen, MD University of São Paulo Billie Lou Wood Professor of Pediatrics Instituto da Criança, Faculty of Medicine Indiana University School of Medicine; São Paulo, Brazil Vice Chairman for Clinical Affairs Director, Section of Pulmonology, Critical Care and Allergy Sonny Dhanani, BSc(Pharm), MD, FRCPC Riley Hospital for Children Assistant Professor Indianapolis, Indiana Pediatric Critical Care Children’s Hospital of Eastern Ontario Waleed M. Maamoun El-Dawy, MBBCh University of Ottawa Clinical Instructor in Pediatrics Ottawa, Ontario, Canada East Carolina University Brody School of Medicine; Fellow-in-Training, Neonatal-Perinatal Medicine Emily L. Dobyns, MD, FCCM University Health Systems of Eastern Carolina Associate Professor Greenville, North Carolina Department of Pediatrics Section of Pediatric Critical Care Medicine Steven Elliott, MD University of Colorado, Denver Research Resident Health Sciences Center Center for Surgical Care Aurora, Colorado Children’s National Medical Center Washington, DC Elizabeth J. Donner, MD, FRCPC Staff Neurologist Helen M. Emery, MBBS Department of Neurology Division Chief The Hospital for Sick Children; Program Director Assistant Professor, Department of Paediatrics (Neurology) Department of Rheumatology University of Toronto Seattle Children’s Hospital Toronto, Canada Clinical & Translational Science Seattle, Washington Lesley Doughty, MD University of Cincinnati Mauricio A. Escobar Jr., MD Cincinnati, Ohio Pediatric Surgeon Pediatric Surgical Services Didier Dreyfuss, MD Mary Bridge Children’s Hospital and Health Center Institut National de la Santé et de la Recherche Médicale Tacoma, Washington UFR de Médecine, Université Paris Diderot Paris, France; Jacqueline M. Evans, MD, PhD Assistance Publique, Hôpitaux de Paris Assistant Professor Hôpital Louis Mourier Children’s Hospital Los Angeles Service de Réanimation Médicale Los Angeles, California Colombes, France Kate Felmet, MD Christine Duncan, MD, MMSc Assistant Professor of Critical Care Medicine and Pediatrics Instructor University of Pittsburgh School of Medicine; Pediatric Hematology/Oncology Medical Director Dana-Farber Cancer Institute Critical Care Transport Team Boston, Massachusetts Children’s Hospital of Pittsburgh Pittsburgh, Pennsylvania Philippe Durand, MD Service de Réanimation Pédiatrique et Néonatale Jeffrey R. Fineman, MD Hôpital de Bicêtre Professor of Pediatrics Assistance Publique, Hôpitaux de Paris Chief, Pediatric Critical Care Medicine Colombes, France Investigator, Cardiovascular Research Institute University of California San Francisco Susan Duthie, MD San Francisco, California Associate Medical Director Pediatric Critical Care Ericka L. Fink, MD University of California San Diego Rady Children’s Hospital Assistant Professor San Diego, California Division of Pediatric Critical Care Medicine Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania x Contributors Richard T. Fiser, MD Stuart Friess, MD Professor of Pediatrics Assistant Professor Division of Pediatric Critical Care Medicine Department of Anesthesiology and Critical Care Medicine University of Arkansas for Medical Sciences College The Children’s Hospital of Philadelphia of Medicine; Philadelphia, Pennsylvania Medical Director, ECMO Program Arkansas Children’s Hospital Bradley P. Fuhrman, MD, FCCM Little Rock, Arkansas Professor of Pediatrics and Anesthesiology University at Buffalo School of Medicine; Frank A. Fish, MD Chief, Pediatric Critical Care Professor of Pediatrics and Medicine Women & Children’s Hospital of Buffalo Director of Pediatric Electrophysiology Buffalo, New York Division of Pediatric Cardiology Vanderbilt University Xiomara Garcia-Casal, MD Nashville, Tennessee Assistant Professor Division of Pediatric Intensive Care James E. Fletcher, MBBS, MRCP, FRCA Department of Pediatrics Department of Anesthesiology Arkansas Children’s Hospital Children’s Healthcare of Atlanta University of Arkansas for Medical Sciences Atlanta, Georgia Little Rock, Arkansas Michael J. Forbes, MD France Gauvin, MD Critical Care Associate Professor University of Pittsburgh School of Medicine Division of Pediatric Intensive Care Pittsburgh, Pennsylvania Department of Pediatrics Sainte-Justine Hospital Amber E. Fort, DO Université de Montréal, Canada Clinical Instructor in Pediatrics Montréal, Canada East Carolina University Brody School of Medicine Fellow-in-Training, Neonatal-Perinatal Medicine J. William Gaynor, MD University Health Systems of Eastern Carolina Associate Professor of Surgery Greenville, North Carolina University of Pennsylvania School of Medicine; Attending Surgeon Norman Fost, MD, MPH The Children’s Hospital of Philadelphia Professor, Department of Pediatrics Philadelphia, Pennsylvania Department of Medical History and Bioethics University of Wisconsin School of Medicine and Public Eli Gilad, MD Health Pediatric Intensive Care Unit Madison, Wisconsin Wolfson Medical Center Holon, Israel Joel E. Frader, MD A. Todd Davis Professor of General Academic Pediatrics James C. Gilbert, MD Department of Pediatrics Director of Pediatric Surgical Services Children’s Memorial Hospital; Department of Surgery Professor, Medical Humanities and Bioethics Huntsville Women and Children’s Hospital Northwestern University Feinberg School of Medicine Associate Clinical Professor of Surgery Chicago, Illinois Department of Surgery University of Alabama School of Medicine Deborah E. Franzon, MD Huntsville, Alabama Associate Medical Director Clinical Assistant Professor Nicole S. Glaser, MD Pediatric Critical Care Associate Professor Lucile Packard Children’s Hospital at Stanford Department of Pediatrics Palo Alto, California University of California Davis School of Medicine F. Jay Fricker, MD Sacramento, California Division Chief, Pediatric Cardiology Congenital Heart Center University of Florida Gainesville, Florida Contributors xi Stuart L. Goldstein, MD Cherissa Hanson, MD Professor of Pediatrics Assistant Professor of Anesthesiology University of Cincinnati College of Medicine Pediatric Critical Care Medicine Division of Nephrology and Hypertension & The Heart Director, Pediatric Rapid Response System Institute University of North Carolina at Chapel Hill Director, Center for Acute Care Nephrology Chapel Hill, North Carolina Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio Cary O. Harding, MD Associate Professor Denise M. Goodman, MD Molecular and Medical Genetics Associate Professor Oregon Health & Science University Pediatric Critical Care Medicine Portland, Oregon Northwestern University Feinberg School of Medicine Chicago, Illinois Mary E. Hartman, MD Department of Critical Care Medicine Ana Lía Graciano, MD, FAAP University of Pittsburgh Pediatric Critical Care Medicine Pittsburgh, Pennsylvania Children’s Hospital Central California Academic Division Chief Pediatric Critical Care, Pediatric Jan A. Hazelzet, MD, PhD, FCCM Residency Program Assistant Professor University of California at San Francisco-Fresno Pediatric Intensive Care Fresno, California Erasmus MC Rotterdam, The Netherlands Björn Gunnarsson, MD Department of Anesthesiology and Intensive Care Christopher M.B. Heard, MBChB, FRCA Akureyri Hospital; Clinical Associate Professor Assistant Professor Anesthesiology, Pediatric Critical Care, Community & University of Akureyri Pediatric Dentistry Akureyri, Iceland Women & Children’s Hospital of Buffalo Buffalo, New York Cecil D. Hahn, MD, MPH, FRCPC Staff Neurologist Ann Marie Heine, PharmD The Hospital for Sick Children; Clinical Pharmacy Coordinator Associate Scientist Department of Pharmacy Program in Neuroscience and Mental Health Women & Children’s Hospital of Buffalo; The Hospital for Sick Children Research Institute; Adjunct Clinical Instructor Assistant Professor The University at Buffalo School of Pharmacy and Department of Paediatrics (Neurology) Pharmaceutical Sciences University of Toronto Buffalo, New York Toronto, Ontario, Canada Lynn J. Hernan, MD Mark Hall, MD Associate Professor, Department of Pediatrics Ohio State University SUNY at Buffalo; Columbus, Ohio Director, PICU Pediatric Critical Care Melinda Fiedor Hamilton, MD, MSc Women & Children’s Hospital of Buffalo Assistant Professor of Critical Care Medicine and Pediatrics Buffalo, New York Department of Critical Care Medicine Children’s Hospital of Pittsburgh of UPMC; Jeremy S. Hertzig, MD Director, Pediatric Simulation Fellow The Pediatric Simulation Center of Children’s Hospital of Pediatric Critical Care Medicine Pittsburgh of UPMC Seattle Children’s Hospital Associate Director, Pediatric Programs Seattle, Washington Peter M. Winter Institute for Simulation, Education, and Research Mark J. Heulitt, MD Pittsburgh, Pennsylvania Professor of Pediatrics, Physiology and Biophysics College of Medicine Yong Y. Han, MD University of Arkansas for Medical Sciences Assistant Professor Little Rock, Arkansas Department of Pediatrics and Communicable Diseases University of Michigan Medical School Ann Arbor, Michigan xii Contributors Julien I.E. Hoffman, BSC Hons(Wits), MD(Wits), Christa C. Jefferis Kirk, PharmD FRCP(London) Intensive Care Unit Clinical Pharmacist Professor of Pediatrics (Emeritus) Seattle Children’s Hospital Senior Member, Cardiovascular Research Institute Seattle, Washington University of California San Francisco San Francisco, California James A. Johns, MD Professor of Pediatrics James C. Huhta, MD Pediatric Cardiology Training Program Director Professor Division of Pediatric Cardiology Women’s Health and Perinatology Research Group Monroe Carell, Jr. Children’s Hospital at Vanderbilt Institute of Clinical Medicine Vanderbilt University University of Tromsø Nashville, Tennessee Tromsø, Norway; Medical Director, Perinatal Services Prashant Joshi, MD All Children’s Hospital Associate Professor of Clinical Pediatrics St. Petersburg, Florida Fellowship Director Lead Physician, Fetal Cardiology Working Group Pediatric Critical Care Medicine Pediatrix Medical Group Women & Children’s Hospital of Buffalo Sunrise, Florida Buffalo, New York Rebecca Ichord, MD Richard J. Kagan, MD, FACS Associate Professor, Neurology & Pediatrics Chief of Staff University of Pennsylvania School of Medicine; Shriners Hospitals for Children; Director, Pediatric Stroke Program Professor of Surgery Children’s Hospital of Philadelphia University of Cincinnati College of Medicine Philadelphia, Pennsylvania Cincinnati, Ohio Andrew Inglis, MD Prince J. Kannankeril, MD, MSCI Associate Professor of Otolaryngology Assistant Professor of Pediatrics Head and Neck Surgery Division of Pediatric Cardiology University of Washington School of Medicine Vanderbilt University Seattle Children’s Hospital Nashville, Tennessee Seattle, Washington Robert K. Kanter, MD Gretchen A. Linggi Irby, PharmD Professor of Pediatrics Intensive Care Unit Clinical Supervisor Director Critical Care & Inpatient Pediatrics Seattle Children’s Hospital SUNY Upstate Medical University Seattle, Washington Syracuse, New York Brian Jacobs, MD, FCCM Oliver Karam, MD Critical Care Medicine Fellow Children’s National Medical Center Division of Pediatric Intensive Care Washington, DC Department of Pediatrics Sainte-Justine Hospital David Jardine, MD Université de Montréal, Canada Associate Professor Montréal, Canada Department of Anesthesiology and Pediatrics University of Washington Kevin R. Kasten, MD Seattle, Washington Surgical Resident University of Cincinnati College of Medicine Alberto Jarillo-Quijada, MD Cincinnati, Ohio Head, Respiratory Therapy Service Department of Pediatric Intensive Care Michael Kelly, MD Hospital Infantil de México Federico Gómez Assistant Professor of Pediatrics Mexico City, Mexico Division of Pediatric Critical Care Medicine Residency Program Director Etienne Javouey, MD Department of Pediatrics Service de Réanimation et d’Urgences Pédiatriques Robert Wood Johnson Medical School Hôpital Femme Mère Enfant des Hospices Civils de Lyon New Brunswick, New Jersey Bron, France