Pediatric acute liver failure is a rare, complex, rapidly progressing, and life-threatening illness. Majority of pediatric acute liver failures have unknown etiology. Pediatric acute liver failure (PALF) can be defined as: 1)Biochemical evidence of acute liver injury in a child with no known evidence of chronic liver disease along with at least one of the following, 2)INR > 1.5, not corrected with vitamin K supplementation, with encephalopathy & INR > 2.0, not corrected with vitamin K supplementation, without encephalopathy. The diagnostic evaluation for PALF should be tailored according to age of presentation. Management of PALF is challenging due to multi-organ system involvement necessitating multidisciplinary approach and potential for rapid deterioration. Medflix brings you an extremely detailed guide to the management of PALF with Dr. Maninder Singh Dhaliwal.

Unknown Origins: The Complexities of Pediatric Acute Liver Failure

Diagnosis of asthma in children is challenging. Personalised asthma action plans are essential, and a significant number of children with asthma do not have one. Asthma attacks should be viewed as Never events. Post-attack reviews are essential to optimise maintenance therapy and prevent future attacks. Both under-diagnosis and over-diagnosis of asthma are important issues, which lead to inappropriate treatment. Following the initial diagnosis, the accuracy of the diagnosis should be confirmed during follow-up. In order to improve patient outcomes, it is essential to stay current on the latest strategies in diagnosis & treatment. Let's together decipher the most recent 2022 Guidelines for Childhood Asthma with our expert faculty Dr. Dhaliwal.

The 2022 Update in Childhood Asthma

Children with critical illnesses require the administration of fluid resuscitation. The clinical findings of dehydration are a manifestation of extracellular volume loss. Fluid and electrolyte issues can be challenging. The ability to correctly identify dehydration has important clinical implications. Clinical features of dehydration lack sensitivity and specificity to estimate the degree of dehydration in children. Therefore, diagnosing dehydration requires a high index of suspicion. Children who present with dehydration and shock have a different physiology from adults. Children can compensate for significant volume loss for a longer period of time than adults because they have a higher cardiac reserve. Initial vital signs may be nearly age-appropriate despite ongoing fluid losses. Children raise their heart rates to maintain cardiac output. Join us live as we discuss some significant changes in fluid management practices for pediatric patients with one of our most prestigious faculty members, Dr. Maninder.

Changing Practice of Fluid Management in Pediatrics

Fever is common in the intensive care unit (ICU) patient and may be associated with increased morbidity and mortality. It is defined as a single temperature of ≥101 degrees F or ≥38.3 C. The fever unique to the ICU settings could result from interventions or therapies provided during ICU care or the patient manifesting new-onset fever due to SIRS, septic, metabolic or neuroendocrine response. The etiology could be either infective or non-infective. Some of the differentials for fevers of non-infectious origin are commonly post-op fever, deep venous thrombosis, infusion reactions, aspiration, adrenal insufficiency & drug associated fever. Let us understand the approach to a new onset fever in the ICU with Dr. Dhaliwal, Sr. Consultant PICU.

New Onset Fever in the ICU : It's not always an infection!

How well do we know the action steps for a choking child? General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. In the OPD environment, the common presenting complaints are trauma, seizures, accidental ingestion, respiratory distress, and toxicologic emergencies. A seemingly well child, can quickly become unresponsive & go into shock in the case of accidental ingestion. Dr. Maninder Dhaliwal, guides us through the routinely encountered pediatric emergencies, risk factors and management!

Common Pediatric Emergencies in the Outpatient Setting

Nosocomial infections are an important preventable infectious complication & a leading cause of mortality in paediatric intensive care unit (PICU). Central line associated bloodstream infections, ventilator associated pneumonia and catheter-associated urinary tract infections are few to name. As the number of interventions and organ system support escalates, the greater are the associated risks. Empiric antibiotic treatment from early reduces mortality in sepsis. But it demands knowledge of the infection rates and of the sources, the pathogens involved as well as the common risk factors. Dr. Maninder Dhaliwal, Senior Consultant PICU, further elaborates.

Infection Control Practices in PICU

The most widely disseminated viral disease carried by mosquitoes, dengue fever has an uncertain clinical course and outcome. The vast majority of dengue cases are children less than 15 years of age. Dengue causes a spectrum of illness from mild fever to severe disease with plasma leakage and shock. The risk of developing a severe dengue infection is greatest among infants and young children with secondary heterologous dengue infections. Dr. Maninder Dhaliwal, a senior paediatric critical care consultant, joins us to contribute to our growing understanding of dengue in kids, including its clinical manifestations, pathogenesis, diagnostic techniques, therapy, and prevention.

Battling against Dengue in children

Bronchitis is an inflammation of the large breathing tubes (bronchi) in the lungs. Acute bronchitis means that the symptoms often develop quickly and don't last long. In children, the most common cause of acute bronchitis is a virus. A cough, fever, runny nose, and body aches are common symptoms. Emergency care for acute bronchitis or exacerbation of chronic bronchitis must focus on ensuring that the child has adequate oxygenation and hydration. Proper care of any underlying disorder is of paramount importance. Approach can vary in different patients depending on various factors. Join live with the expert to understand how to treat pediatric bronchitis.

Approach to the Case of Bronchitis in Children

Senior Consultant PICU & Pediatric Pulmonology | Amrita Hospital, Faridabad

Dr. Maninder Singh Dhaliwal

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