4.A Supporting failing organs
A short summary in PICUlearn's own words. The original wording is in the publisher's document.
- 4.A.1 Oxygen therapy, non-invasive and invasive ventilation
- 4.A.2 Mechanical circulatory support including ECMO and VADs
- 4.A.3 Renal replacement therapy
76 practice questions on this
Join free to practise them.
Course modules
- Ventilation basicsPICU BasicsCourse module
- Endotracheal and tracheostomy suctioningPICU ProceduresCourse module
- Planned extubationPICU ProceduresCourse module
- Setting up high flow and non-invasive ventilationPICU ProceduresCourse module
- Airway basics and the intubated childPICU BasicsCourse module
- Peritoneal dialysis catheter and starting PD: the bedside rolePICU ProceduresCourse module
Videos
- Non-transplant Options in Pediatric Acute Liver Failure by A. Deep | OPENPediatricsOPENPediatricsVideo
- Continuous Renal Replacement Therapy Explained: CRRT and Dialysis BasicsWBM Emergency & Critical CareVideo
- Primer On Use Of High Flow Nasal Cannula For Pediatric BronchiolitisThe Center for Medical EducationVideo
- CPAP vs BiPAP - Differences You Need To Know!Conan Liu, M.D.Video
- Pedi ECMO - Respiratory Management in Neonatal and Pediatric ECMOPediECMO Education CommitteeVideo
- High Flow Nasal CannulaMount Sinai Health SystemVideo
- Renal replacement therapy: what's new?ESICMVideo
- Under the hood: How modern ventilators really work?WFPICCSVideo
- 4. A Basic guide to NIV in the acute settingIntensive Care Education & Training (ICET)Video
- What is Peritoneal Dialysis?OPENPediatricsVideo
- Challenging Scenarios in Pediatric ECMO with PediECMO, PCICS, and Peds IntensivaPediECMO Education CommitteeVideo
- Pediatrics | Nelson Based Teaching | ECMO | Raaonline #pediatrics #nbt #ecmoRaaonline.co.inVideo
- PG Teaching: Renal Replacement Therapy - Dr.Ajay Vijayan, Paediatric Intensivist, BMHShaji Thomas JohnVideo
- PediECMO - Cardiac decompression on ECMOPediECMO Education CommitteeVideo
- Renal Replacement Therapy - Module 2. Dr Jose Chacko | Webinar CAMPUSWebinarcampusVideo
- Pediatric Mechanical Ventilation TransitionsAmerican Thoracic SocietyVideo
- Lung Recruitment and prone positioning in pediatric ventilationWFPICCSVideo
- Ventilators for BEGINNERS!!! Understand these concepts forever!!!Tala Talks NICUVideo
- VV ECMO Part 1: Who to cannulate to VV and how to get involvedZac HodgesVideo
- SinapsTalk 29.0: "Introducing Basic Extracorporeal Membrane Oxygenation (ECMO) in Pediatrics"Sinaps Medical EducationVideo
- ECMO Explained: Extracorporeal Membrane Oxygenation Basics and OverviewWBM Emergency & Critical CareVideo
- Modes of Therapy - CRRT Explained!ICU AdvantageVideo
- Managing Bronchiolitis & Asthma in Community Hospitals Pending Transfer to Tertiary Critical CareThe Hospital for Sick Children (SickKids)Video
- Pediatric ECMO Cannulation Strategies in Refractory Septic Shock by G. MacLaren | OPENPediatricsOPENPediatricsVideo
- Asthma by G. Wolf | OPENPediatricsOPENPediatricsVideo
- Essentials in Paediatric Oxygen Therapy & Heated High FlowThe Hospital for Sick Children (SickKids)Video
- The Ultimate ICU Basics Guide | Ventilation, Shock, Pressors & Renal ReplacementWBM Emergency & Critical CareVideo
- Hands-on Mechanical Ventilation with G. Wolf, B. Walsh | OPENPediatricsOPENPediatricsVideo
- High Flow Nasal CannulaCharlie's Emergency MedicineVideo
- What is ECMO? The basics explained.ICU AdvantageVideo
- Introduction to Mechanical Ventilation by G. Wolf | OPENPediatricsOPENPediatricsVideo
- Book a Date to RENOVATESCCMVideo
- Oxygen Delivery DevicesICU AdvantageVideo
- Choosing the Right Support –A Debate on HHFNC vs NIVWFPICCSVideo
- Peritoneal Dialysis by S. Su, A. Olszewski | OPENPediatricsOPENPediatricsVideo
- Renal Replacement Therapy Masterclass: ICU Guide from Basics to AdvancedWBM Emergency & Critical CareVideo
- PEEP, recruitment and proning: Opening the lung without bursting itWFPICCSVideo
- Experts On Air - High flow nasal cannula - HFOT outside of critical careHamilton MedicalVideo
- EPISODE -30 NON INVASIVE VENTILATOR METHODS | RESPIRATORY PHYSIOLOGY IN PRETERM NEONATES & HHFNCNational Neonatology Forum Karnataka ChapterVideo
- Basic Concepts on Non-Invasive Ventilation by M. Pons | OPENPediatricsOPENPediatricsVideo
- Neonatal Pigtail PD Catheter Insertion | Institute of Child Health, KolkataPediatric Nephrology ICH KolkataVideo
- What is CRRT? - CRRT Explained!ICU AdvantageVideo
- Acute Ventilation in PaediatricsThe Hospital for Sick Children (SickKids)Video
- Basic Vent Modes MADE EASY - Ventilator Settings ReviewedICU AdvantageVideo
- Continuous Renal Replacement Therapy | Webinar | Aster RVAster Hospitals, BangaloreVideo
- PICU: Physiology of Mechanical Ventilation (Arabic/English)Aly Aly, M.D FAAPVideo
- Beyond Tidal Volume: Driving Pressure and Lung Protective Ventilation in PICUWFPICCSVideo
- VV vs VA ECMO Explained!ICU AdvantageVideo
- Demonstration of Extubation Procedure by C. Smallwood | OPENPediatricsOPENPediatricsVideo
- Breath by breath: the real science of gas exchangeWFPICCSVideo
- Basics of Paediatric Mechanical VentilationPediatrics with Dr Syed KazmiVideo
- Renal Replacement Therapy: Peritoneal DialysisEdu-PICVideo
- PARDS: Pediatric Acute Respiratory Distress Syndrome Ep05 | Peds Critical Care BoardsAPPNA Pediatrics Video
- Extubation CriteriaKenneth John, MDVideo
- CPAP and NIV in Pediatrics: How to Choose the Right Ventilator?BreasVideo
- General Ventilator Set-up by N. McGowan | OPENPediatricsOPENPediatricsVideo
- Setting the Ventilator in pARDS: The First Six HoursWFPICCSVideo
Guidelines and evidence
- Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC).European Society for Paediatric and Neonatal Intensive Care (PEMVECC/ESPNIC), 2017Guideline or evidence
- High-flow nasal cannula oxygen therapy for children with bronchiolitis: Implementation of a national guideline.Acta Paediatrica, 2025Guideline or evidence
- Consensus statement of the Paediatric Anaesthesiology and Intensive Therapy Section of the Polish Society of Anaesthesiology and Intensive Therapy on the use of VV ECMO in paediatric patients for the treatment of acute respiratory failure.Polish Society of Anaesthesiology and Intensive Therapy (Paediatric Section), 2026Guideline or evidence
- Experts' guidelines of intubation and extubation of the ICU patient of French Society of Anaesthesia and Intensive Care Medicine (SFAR) and French-speaking Intensive Care Society (SRLF) : In collaboration with the pediatric Association of French-speaking Anaesthetists and Intensivists (ADARPEF), French-speaking Group of Intensive Care and Paediatric emergencies (GFRUP) and Intensive Care physiotherapy society (SKR).SFAR/SRLF (with ADARPEF, GFRUP, SKR), 2019Guideline or evidence
- Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric ECMO Anticoagulation CollaborativE (PEACE) / Society of Critical Care Medicine, 2024Guideline or evidence
- Oxygen therapy for acute respiratory infections in young children in developing countriesWorld Health Organization, 1993Guideline or evidence
- Updated guideline: paediatric emergency triage, assessment and treatment: care of critically-ill childrenWorld Health Organization, 2016Guideline or evidence
- Oxygen therapy for children: a manual for health workersWorld Health Organization, 2016Guideline or evidence
- WHO-UNICEF technical specifications and guidance for oxygen therapy devicesWorld Health Organization (WHO/UNICEF), 2019Guideline or evidence
- Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2).Pediatric Acute Lung Injury Consensus Conference (PALICC-2), 2023Guideline or evidence
- Effect of high-flow nasal oxygen therapy on perioperative hypoxemia in children: a systematic review and meta-analysis.BMC Anesthesiology, 2025Guideline or evidence
- Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children: a cochrane systematic review and meta-analysis.Cochrane / Critical Care, 2015Guideline or evidence
- Management of Bleeding and Thrombotic Complications During Pediatric Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric ECMO Anticoagulation CollaborativE (PEACE), Pediatric Critical Care Medicine, 2024Guideline or evidence
- Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference.Pediatric ECMO Anticoagulation CollaborativE (PEACE), SCCM, 2024Guideline or evidence
- As-needed endotracheal suctioning protocol vs a routine endotracheal suctioning in Pediatric Intensive Care Unit: A randomized controlled trial.Colombia Medica (Universidad del Valle) / Hospital Pablo Tobón Uribe, 2018Guideline or evidence
- Role of extracorporeal membrane oxygenation in children with sepsis: a systematic review and meta-analysis.Critical Care (BioMed Central), 2020Guideline or evidence
- Anticoagulation Monitoring and Targets: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric ECMO Anticoagulation CollaborativE (PEACE), PCCM/SCCM, 2024Guideline or evidence
- Anticoagulant Medications: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric ECMO Anticoagulation CollaborativE (PEACE), PCCM/SCCM, 2024Guideline or evidence
- Programs and processes for advancing pediatric acute kidney support therapy in hospitalized and critically ill children: a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference.Acute Disease Quality Initiative (ADQI), 2024Guideline or evidence
- Neurally Adjusted Ventilatory Assist vs. Conventional Mechanical Ventilation in Adults and Children With Acute Respiratory Failure: A Systematic Review and Meta-Analysis.Frontiers in Medicine, 2022Guideline or evidence
- Association of Arterial Hyperoxia With Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis.JAMA Network Open, 2022Guideline or evidence
- The Infant KIdney Dialysis and Utrafiltration (I-KID) Study: A Stepped-Wedge Cluster-Randomized Study in Infants, Comparing Peritoneal Dialysis, Continuous Venovenous Hemofiltration, and Newcastle Infant Dialysis Ultrafiltration System, a Novel Infant Hemodialysis Device.Pediatric Critical Care Medicine (SCCM/WFPICCS), 2023Guideline or evidence
- Nutrition in Critically Ill Children with AKI on Continuous RRT: Consensus Recommendations.Kidney360 (multidisciplinary paediatric nephrology and nutrition expert panel), 2024Guideline or evidence
- Haemodialysing babies weighing <8 kg with the Newcastle infant dialysis and ultrafiltration system (Nidus): comparison with peritoneal and conventional haemodialysis.Pediatric Nephrology (Springer), 2014Guideline or evidence
- Efficacy and safety of high flow nasal oxygen for children with bronchiolitis: systematic review and meta-analysis.BMJ Open Respiratory Research, 2021Guideline or evidence
- Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial.Lancet (BIDS trial, NIHR HTA), 2015Guideline or evidence
- A randomised controlled trial of an automated oxygen delivery algorithm for preterm neonates receiving supplemental oxygen without mechanical ventilation.Acta Paediatrica, 2014Guideline or evidence
- FIRST-line support for Assistance in Breathing in Children (FIRST-ABC): a multicentre pilot randomised controlled trial of high-flow nasal cannula therapy versus continuous positive airway pressure in paediatric critical care.Critical Care (BioMed Central), 2018Guideline or evidence
- Noninvasive high-frequency oscillatory ventilation as respiratory support in preterm infants: a meta-analysis of randomized controlled trials.Respiratory Research, 2019Guideline or evidence
- Association of Extubation Failure Rates With High-Flow Nasal Cannula, Continuous Positive Airway Pressure, and Bilevel Positive Airway Pressure vs Conventional Oxygen Therapy in Infants and Young Children: A Systematic Review and Network Meta-Analysis.JAMA Pediatrics, 2023Guideline or evidence
- Randomised controlled trial of oxygen therapy and high-flow nasal therapy in African children with pneumonia.Intensive Care Medicine (COAST trial investigators), 2021Guideline or evidence
- 'Nasal mask' in comparison with 'nasal prongs' or 'rotation of nasal mask with nasal prongs' reduce the incidence of nasal injury in preterm neonates supported on nasal continuous positive airway pressure (nCPAP): A randomized controlled trial.PLoS One, 2019Guideline or evidence
- Extracorporeal life support in pediatric trauma: a systematic review.Trauma Surgery & Acute Care Open (BMJ), 2019Guideline or evidence
- Phenotypes based on respiratory drive and effort to identify the risk factors when P0.1 fails to estimate ∆PES in ventilated children.Critical Care (BioMed Central), 2024Guideline or evidence
- Estimation of inspiratory effort using airway occlusion maneuvers in ventilated children: a secondary analysis of an ongoing randomized trial testing a lung and diaphragm protective ventilation strategy.Critical Care (BioMed Central), 2023Guideline or evidence
- High-Frequency Oscillation vs Mechanical Ventilation for Neonatal Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.JAMA Network Open, 2026Guideline or evidence
- Comparison of hemodynamic consequences of hand ventilation versus machine ventilation for transportation of post-operative pediatric cardiac patients.Annals of Cardiac Anaesthesia, 2023Guideline or evidence