with the development of emergency medicine with respiratory failure in children,imaging has played an important role in critical care of children.Critically ill patients often require ventilator,which need to use imaging methods to monitor the trerapeutic effects and adverse reactions.By imaging tests.it can be helpful in understanding the nature of lung diseases,verifying intubation's location,monitoring ventilatory complications,assessing the comprehensive effect of ventilator,and facilitating ventilator parameter adjustment and mode selection.

Septic shock is the most common complication in severe septic patients.These patients clinically present shock manifestations due to capillary leak,extravasation in the third space,the anomaly distribution of blood volume,and decreased effective circulating volume,secondary to the severe inflammatory reaction.Early reasonable fluid resuscitation is one of the main therapy to deduce the mortality of septic shock.The time point of fluid resuscitation,volume control,and therapeutic evaluation play important role in the treatment of septic shock.

The mechanism of sepsis is complicated,currently the treatment of severe sepsis is still a challenge.When infected,the body would release cytokines and inflammatory mediators,resulting in out of control of inflammatory reaction and disorder of immune system.Furthermore,sepsis and severe sepsis will be developed.The technique of continuous blood purification (CBP)can powerfully clear solute as water,metabolic wastes,toxic substances,cytokines and inflammatory mediators.Now this technique is not only applied in renal disorders,but also widely used in rescue treatment for critically ill patients.Recently,the guide of sepsis recommended CBP as a method of treating severe sepsis.With CBP application in the early stage of children severe sepsis,it can improve function of heart and lung function,renal function,immune function,coagulation function,and etc.CBP is becoming more and more important in the treatment of children severe sepsis.There are some remaining problem to be resolved,and the individaulized treatment for children sepsis is the focus in the future study.

Fulminant myocarditis is a myocarditis of acute hemodynamic disorder as the main per-formance,with rapid progression and high mortality. There is no specific medicine for this disease currently, which is treated with symptomatic and supportive therapy in general. The application of mechanical support is an effective measure for the treatment of acute fulminant myocarditis in recent years. In this article,we made a review on the application of extracorporeal membrane oxygenation and left ventricular assist device in ful-minant myocarditis at present.

Tracheal gas insufflation is a non conventional respiratory support technology. It might avoid severe CO2 retention in lung protective ventilation strategy, reduce ventilator-associated lung injury, which was recommented recently. In this article,we made a brief introduction of the principle,classification and clinical applications of tracheal gas insufflation technique.

Acute kidney injury(AKI) is a clinical syndrome characterized as acute renal dysfunction with difficult treatment and high mortality,and is one of the most common complications in critically ill patients.Till now,the blood creatinine and urine volume were widely used to diagnose AKI in clinic,but both of them could not represent the change of renal function timely and accurately.Some new biomarkers provide new probable criteria for early diagnosis and treatment of AKI.In this paper,we make a review on new biological markers focused on AKI research at present.

Severe sepsis and septic shock is a clinical syndrome with sequential organ dysfunction or tissue hypoperfusion induce by sepsis.Although early,adequately and rapidly initial resuscitation plays pivotal role in the management,but infusion of albumin,plasma,red blood cell,platelet,gamma globulin and other blood products and the immunological support with ulinastatin combined with thymosin,blood purification and anti CD14 monoclonal antibody therapy also play an important role.

Acute respiratory distress syndrome(ARDS) is a common critical disease in pediatric patients,and mechanical ventilation is one of the most important methods for respiratory support.High frequency oscillation ventilation,which has these characteristics of low tidal volume,low airway pressure,and low alveolar injury,is a safe and effective treatment of ARDS.This article will elaborate about current status and recognition of high frequency ventilation in ARDS.

Respiratory tract infection is a commo n disease in hc ildren.The pathoeg ns of respiratory trract infection are very complex, includingvi ruses, bactre ia, mycoplasma pneumoniae, and fugn al, etc.The research of respiratro y pathogens is imp ortant for clinical diagnosis na d treatmento f respiratory tract infec-tions in children.In this article,we make a brife introduction to the ca qiu sition and interpretation of respirato-ry pathogens in cih ldren.

Fulminant myocarditis is a myocarditis of acute hemodynamic disorder as the main per-formance,with acute onset,rapid progression and high mortality.It will lead to serious arrhythmia and cardic shock,which may be delay to the diagnosis.There is no specific medicine for this disease currently,which is treated with symptomatic and supportive therapy in general.The application of extracorporeal membrane oxy-genation is an effective measures for the treatment of acute fulminant myocarditis in recent years.In this arti-cle,we made a review on the application of extracorporeal membrane oxygenation in fulminant myocarditis at present.