title: Immunologic and Infectious Diseases in Pediatric Cardiac Critical Care: Proceedings of the 10th International Pediatric Cardiac Intensive Care Society Conference.
abstract: Since the inception of the Pediatric Cardiac Intensive Care Society (PCICS) in 2003, remarkable advances in the care of children with critical cardiac disease have been developed. Specialized surgical approaches, anesthesiology practices, and intensive care management have all contributed to improved outcomes. However, significant morbidity often results from immunologic or infectious disease in the perioperative period or during a medical intensive care unit admission. The immunologic or infectious illness may lead to fever, which requires the attention and resources of the cardiac intensivist. Frequently, cardiopulmonary bypass leads to an inflammatory state that may present hemodynamic challenges or complicate postoperative care. However, inflammation unchecked by a compensatory anti-inflammatory response may also contribute to the development of capillary leak and lead to a complicated intensive care unit course. Any patient admitted to the intensive care unit is at risk for a hospital acquired infection, and no patients are at greater risk than the child treated with mechanical circulatory support. In summary, the prevention, diagnosis, and management of immunologic and infectious diseases in the pediatric cardiac intensive care unit is of paramount importance for the clinician. This review from the tenth PCICS International Conference will summarize the current knowledge in this important aspect of our field.
authors.affiliation: Department of Pediatrics (Cardiology), Stanford University School of Medicine, Palo Alto, CA, USA daxelrod@stanford.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Axelrod
authors.affiliation: Section of Pediatric Cardiac Critical Care Medicine, University of Alabama at Birmingham, Children's of Alabama, Birmingham, AL, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Alten
authors.affiliation: Division of Critical Care Medicine, George Washington University School of Medicine, Children's National Health System, Washington, DC, USA Division of Cardiology, George Washington University School of Medicine, Children's National Health System, Washington, DC, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Berger
authors.affiliation: The Ohio State University College of Medicine, Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Hall
authors.affiliation: Intensive Care Unit, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Thiagarajan
authors.affiliation: Section of Critical Care Medicine and Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Bronicki
mesh_terms: D002648:Child; D003226:Congresses as Topic; D003422:Critical Care; D006331:Heart Diseases / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007154:Immune System Diseases / Q000150:complications*; D007239:Infections / Q000150:complications*; D010372:Pediatrics; D012955:Societies, Medical
keywords: cardiopulmonary bypass; congenital heart disease; congenital heart surgery; infection; inflammation; inflammatory cells (neutrophils; inflammatory mediators; ischemia/reperfusion; macrophages); monocytes; organ preservation; pediatric