ABSTRACT
Pediatric trauma patients with severe injuries will require admission to an intensive-care unit (ICU) for close monitoring and/or ongoing resuscitation and support. ICU management is complex and requires the active participation of pediatric surgeons, intensivists, and subspecialists to fully address patients' injuries. This chapter focuses on the principles of critical care and management techniques that are most applicable to the critically injured trauma patient. Invasive blood pressure monitoring may be obtained through either percutaneous arterial cannulation or cutdown techniques, with the radial and femoral arteries being the most common sites for access. Management of hemorrhagic shock in the pediatric population depends on an accurate assessment of blood loss and size-appropriate goals for resuscitation. Septic shock may complicate trauma as a result of infection during treatment in the ICU. Noninvasive positive pressure ventilation (NPPV) may be used as either a preventive strategy in patients at risk for respiratory failure or as primary therapy.
