Fluid management is one of the regular aspects of care in pediatric intensive care unit (PICU) setting, and its importance has been stressed in previous studies. Fluid resuscitation, as part of fluid management, may be needed to maintain intravascular volume, and prior studies showed that early aggressive fluid resuscitation may improve outcome in critical illness, especially in endothelial-dysfunction associated conditions. Unfortunately, this routine management often leads to the development of positive fluid balance and, consequently, fluid overload. Many evidences have stated that excessive fluid administration is closely associated with negative effects for children who were admitted in PICU. Moreover, fluid balance before PICU admission is also important because uncertainty about quantification fluid balance before admission can lead to underestimated fluid overload.
Part of the book: Current Topics in Intensive Care Medicine
Traumatic brain injury (TBI) in children occurs as a result of a sudden bump, roll, or jerk to the head or a penetrating injury to the head that interferes the normal brain function. Traumatic brain injury (TBI) is the leading cause of death and disability in children. More than half a million children present annually to the emergency department for TBI-related visits, and resulting in the death of >7,000 children annually in the United States, with highest incident rates seen in children aged 0–4 years and adolescents aged 15 to 19 years. In Indonesia, from Riskesdas data in 2013 shows the incidence of head trauma in children is about 0.5% of the population from other injury rates. Pediatric TBI is associated with an array of negative outcomes, including impaired cognitive and academic abilities, social impairments, and behavioral problems. The scalp is highly vascularized and a potential cause of lethal blood loss. Even a small loss of blood volume can lead to hemorrhagic shock in a newborn, infant, and toddler, which may occur without apparent external bleeding.
Part of the book: Advancement and New Understanding in Brain Injury