Severe hand foot and mouth disease can lead to death when accompanied by neurogenic pulmonary edema. Early identifying involvement of central nervous system, focusing on the evidences of excited sympathetic nerve tension and high risks of neurogenic pulmonary edema, monitoring respiratory rate,dyspnea, cyanosis, fine and medium rales in lungs are critical to prognosis. Managing fluid loading strictly, decreasing intracranial hypertension, supporting actively respiratory function and strengthening airway management are key points for the treatment of neurogenic pulmonary edema.

Tetramine poisoning still occurs and seriously impairs children' s health. Some children suffered from brain injury or death. Diagnosing accurately as soon as possible, eliminating poison rapidly,using antidotes timely and controlling convulsion quickly are the crucial treatment principles.

In addition to parameter setting and mechanics monitoring,respiratory wavetorms are helpful for respiratory therapist in getting the real-time changes of respiratory mechanics and dynamically adjusting ventilator parameters.The curves of pressure to time,flow to time and volume to time accompanied by the loops of pressure to volume.flow to volume and pressure to flow can be displayed dynamically in new type ventilators.It will be definitely helpful to us to make good use of ventilator.

The key mechanism of severe infection (sepsis) is systemic inflammatory reaction syndrome. Continuous blood purification (CBP) is helpful for treatment of sepsis through removing medium and large molecular weight inflammatory mediators. Clinical application and lab researches have confirmed that CBP can stabilize cardiopulmonary function in patients with severe sepsis. Continuous veno-venous hemodiafiltration, continuous plasma filtration absorption and high volume hemofiltration can play a role in lowering inflammatory mediators in plasma and tissue. CBP has revealed a good prospect in the treatment of severe sepsis in children.

Training technologies on life support for pediatric critical illness mainly include basic life support,pediatric advanced life support,neonatal resuscitation program,pediatric trauma life support,pediatric fundamental critical care support,and simulation-based medical education.This article introduced and summarized the contents of training technologies on life support for pediatric critical illness,and elucidated the status on each project and its vision.

Hypertensive emergencies,though uncommon in children,are often involving severe organ dysfunction and potentially life threatening.Early recognition of hypertensive crisis and properly management to control the blood pressure are the key points of the treatment.Drug therapy is an important antihypertensive treatment.

Shock is the hypoperfusion or blood flow distribution abnormality and leads to systemic tissue hypoperfusion and organ dysfunction.Cardiac output and tissue perfusion pressure are major factors affecting tissue and organ peffusion.Continuous assessment of hemodynamic parameters is crucial for the diagnosis and treatment of shock.The pulse indicator continuous cardiac output technology combines hemodynamic monitoring and volumetric measures to assess a variety of hemodynamic parameters including cardiac output,afterload and volume,which is a kind of low-risk,convenient,accurate,and continuous technology.

Sepsis is a group of clinical syndrome in response to overwhelming inflammation,which is a major problem associated with high morbidity and mortality among critically ill patients.Recently,an abundance of basic and clinical findings suggest that stem cell can be attributed to anti-inflammatory,tissue healing and immunomodulatory,which may provide a promising idea in the treatment of sepsis.

High-frequency ventilation ( HFV) is theoretically an ideal ventilatory mode for lung pro-tection. It also delivers extremely small tidal volumes near to or less than the anatomically invalid cavity (about 2ml/kg) at very high respiratory frequencies (recognized ventilation frequency about 4 times more than the normal range) . Compared to the conventional mechanical ventilation,HFV makes use of lung-open mode,with low tidal volume, low airway pressure, low thoracic pressure and end-exhaling pressure effect, which can avoid recruitment/derecruitment of alveoli to reduce pressure injuries on lung tissue and airway. Nowadays,more and more critical care practitioners implement this ventilation mode. We reviewed the princi-ples,classification,parameters,and clinical indications of HFV in this article.

The 2012 version of international guidelines for management of severe sepsis and septic shock got re-revised on the basis of the 2008 version.For pediatric severe sepsis,the 2012 version enforces initial resuscitation;develops detailed ant-infection measures;stresses isotonic crystalloid fluid resuscitation and the use of albumin,hetastarch is no longer recommended ;reduces the value of early use of dopamine,and clears the use of corticosteroids indications and the use of blood products;mechanical ventilation is recommended to use lung protective ventilation strategy; standardizes sedation and analgesia applications; clears the level of blood glucose control;others include blood purification,nutrition,stress ulcer prevention recommendations.