Pediatric Neurocritical Care

Abstract

Pediatric Neurocritical Care is an emerging multidisciplinary field of clinical and experimental medicine. While there are challenges to implementing specialized units for pediatric neurologic critical care, and limited evidence on which to base clinical practice, several models now exist for pediatric neurocritical care programs in centers that are contributing to the development of treatment guidelines and protocols; including multimodal neuromonitoring [1, 2]. Recent multi-center studies investigating pediatric brain injury in stroke, status epilepticus, and hypothermia after cardiac arrest and traumatic brain injury have served to promote the feasibility of accomplishing brain-directed research in children [3–7]. Several organizations, such as the Pediatric Emergency Care Applied Research Network (PECARN) and the Pediatric Neurocritical Care Research Group (PNCRG) are working on advancing care in highly specialized training programs across the United States. Pediatric neurocritical care exists thanks to technological advances in pediatric critical care, neurology, neurosurgery, and anesthesiology. The main goal of pediatric neurocritical care is to improve outcomes in infants and children with life-threatening neurologic injuries, and to prevent the development of secondary neurologic and non-neurologic injuries. This chapter briefly covers some of the most common neurologic conditions encountered in the pediatric intensive care unit (PICU).