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Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...

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Updated: Jul 5, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

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Published on: June 11, 2012

Endocrine issues in the pediatric intensive care unit.

Lowell Clark1, Catherine Preissig, Mark R Rigby

  • 1Mercer University School of Medicine, Macon, GA, USA. clark.lowell@mccg.org

Pediatric Clinics of North America
|May 27, 2008
PubMed
Summary

This review covers pediatric endocrine emergencies in the intensive care unit, focusing on critical illness hyperglycemia and relative adrenal insufficiency. It details the neuroendocrine stress response and practical management scenarios.

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Published on: May 2, 2017

Area of Science:

  • Pediatric Endocrinology
  • Critical Care Medicine
  • Neuroendocrinology

Background:

  • Endocrine emergencies are common in pediatric intensive care units (PICUs).
  • Diabetic ketoacidosis is excluded, focusing on other critical endocrine issues.
  • Understanding the neuroendocrine stress response is key in critical illness.

Purpose of the Study:

  • To review key endocrine concerns in the PICU, excluding diabetic ketoacidosis.
  • To discuss critical illness hyperglycemia and relative adrenal insufficiency.
  • To provide insights into managing common endocrine scenarios in critical care.

Main Methods:

  • Literature review of endocrine issues in pediatric critical care.
  • Description of the sympathoadrenergic stress response.
  • Discussion of selected common clinical scenarios.

Main Results:

  • Highlights the significance of hyperglycemia in critical illness.
  • Explains the concept and implications of relative adrenal insufficiency.
  • Provides a framework for addressing endocrine dysregulation in critically ill children.

Conclusions:

  • Effective management of endocrine issues is vital for PICU outcomes.
  • Critical illness hyperglycemia requires careful monitoring and management.
  • Recognition and treatment of relative adrenal insufficiency can improve patient prognosis.