Gastrointestinal failure is often secondary to a variety critically illness such as sepsis,severe hypoxia and severe gastrointestinal diseases and characterized gastrointestinal mucous lesion,dysfunction of gastrointestinal motility and barrier.It is a pivotal factor influencing the outcome of critically ill patients.Early diagnosis and appropriate treatment is important to improve the outcome of patients,but for a long time there was no unified definition and standard of diagnosis and also no consensus of therapeutic regimen because of lacking specific criteria of assessment.In recent years,the new conception of acute gastrointestinal injury with its four grades of severity and therapeutic regimen based on the grades were proposed in adult ICU field which is worth learning for pediatrician.In this review,the etiology of gastrointestinal failure and the new concepts on its different grades and grading treatment were discussed.

Increased attention to intra-abdominal pressure (IAP) have led to an exponential growth in research relating to intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in the field of critical care medicine in recent years.Active prevention and therapy of IAH and ACS are important to improve the prognosis of critically illness patients.In domestic pediatric field the attention to IAH and ACS is not enough.This article introduces the main contents of updated consensus definitions and clinical practice guidelines on IAH and ACS from the World Society of the Abdominal Compartment Syndrome.The poppers are to guide the diagnosis,prevention and therapy to IAH and ACS for pediatrician.

Osmotherapy is the most common strategy for treatment of brain edema and intracranial hyperten-sion. Mannitol and hypertonic saline are most commonly used in clinical practice. Compared with mannitol,hypertonic saline may have a more efficient and safety in decreasing intracranial hypertension with increasing used resent years. The review introduces the application of hypertonic saline in pediatric clinical practice.

Myocarditis refers to inflammatory disease of the myocardium caused by variety patho-gens,90%of patients are asymptomatic.A new and effective screening method is badly needed.Lake Louise standard cardiac MRI has become the non-invasive alternative diagnostic methods for myocarditis(instead of myocardial biopsy),as it can not only to show myocardial injury site,but can also reveal the extent of myo-cardial edema,fibrosis repair in late phase.

Central nervous system (CNS) damage caused by enterovirus 71 (EV71) infection is the main reason for its mortality and morbidity.In recent years,survival rate of EV71 infection-associated CNS damage in children is improved.However,the condition of survivors with sequelae is still unclear.It is important to understand its prognosis in order to improve the life quality of children with CNS damage after EV71 infection.In this paper,the prognosis and sequelae classifications of EV71 infection-associated CNS damage are described.

Mechanical ventilation is an important life support method.Correct parameter adjustment of mechanical ventilation depends on assessment of Patient's respiratory and the effectiveness of mechanical venfilation.Blood gas monitoring is the most important way to assess the effectiveness of mechanical ventilation.Guidance of blood gas monitoring in parameter adjustment of mechanical venfilation is the key of successful mechanical ventilation.

Carefully evaluation of cardiovascular function in children with septic shock is the basis of appropriate therapy.Clinical methods of cardiovascular function evaluation include clinical manifestation,hemodynamic momtoring and laboratory test of tissue oxygenation.Evaluation of cardiovascular function should combine all results from different methods and should be dynamically monitored with the development of septic shock.

Critically ill children suffer from pain and anxiety additionally in the face of severe organ dysfunction and often require analgesia and sedation.Different medications and combinations of medications can be used to achieve the desired effect.It is also important to keep in mind the possible adverse reactions and side effects associated with each medication.The side effect of the medications often used in children and prevention and therapy of common complications associated with analgesia and sedation is reviewed.

Enterovirus 71 (EV71) is one of the most important causes of hand-foot-mouth disease and herpangina.EV71,due to its neurotropic nature,can also cause severe complications of the central nervous system than other types of enterovirus.EV71 infection also causes devastating syndromes such as acute pulmonary edema,pulmonary hemorrhage and cardiopulmonary failure.In this review,clinical manifestations and the pathogenesis of central nervous system dysfunction after EV71 infection were described.

Objective To investigate the risk factors of sepsis associated encephalopathy( SAE) in children.Methods We collected the clinical data of 152 cases of children with sepsis admitted in PICU of Shenzhen Children′s Hospital from June 2013 to April 2015.All 152 cases were divided into the SAE group (n=46) and non SAE group(n=106).Single factor analysis and multi-fatc or Logsi ticr egression analysis were used to study the risk fatc ors of the occurrence and mro tality of SAE in children.Re sults The inci-dence of SAE was 30.3%amongs epsis.The mortality rate of children with SAE was obviously higher than that of children without SAE(17.4%,8/46 vs.1.9%,2/106; χ2 =13.234,P<0.001).Lo gistic regression analysi showed that coagulation disorder,hepatic insfu ficiency and peid atir c cliin cal illness score≤80 were indpe endent risk factro s of SAE.C oagulationd isorder was independent riks facot rs of SAE death.Conclusion The incidence and mortality of SAE are high.Ch ildren with coa gulta ion dsi order,hepatic insufficiecn y and pediatric clinical illness score≤80 shouldb e observed lc osely.