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.

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.

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.

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.

[Abts ract] Ven tilato r-associated pneumonia ( VAP) is one fo the most common nosocomila infec-tions of mechanically ventilated children in PICU.VAP not only contributes to prolong ed hospital and PICU lengt h of stay,but asl o icn reaseds medical cost,mortality and mo rbility in critiac lly ill children.It′s an urgent task to prevent VA P in pediatrici ntensive care medicine.The aimo f the articel was to intor duce the epidemi-ology,risk factors,prevention strategya nd practice in children.The article reviewed guidelines of strategies to prevent VAP in pediatric patients.

The mi nimizign time on mechanical ventilait on is one of the great importna t issues in crit-ical ill patienst ,only limited guidance on weaing and extubation is available from the pediatric literature.T he clinical application ofni dicta ions for weaning are even less clear,and the protocol-based wae ningw ith sponta-neous breaht ing trail is a feasible way in pediatric intensive care unit.

Septic shock remains a major cause of morbidity and mortality in intensive care unit(ICU). Abun-dant fluid resuscitation is one of the most common therapies for septic shock patients;but some fundamental questions about its efficacy and safety remain. In this paper,recent insight derived from clinical trials in terms of fluid type,dose, rate and toxicity are discussed.