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FUHRMAN & ZIMMERMAN’S

PEDIATRIC
CRITICAL CARE

FUHRMAN & ZIMMERMAN’S
PEDIATRIC
CRITICAL CARE
JERRY J. ZIMMERMAN, MD, PhD, FCCM
Faculty, Pediatric Critical Care Medicine, Seattle Children’s
Hospital, Harborview Medical Center, University of
Washington School of Medicine, Seattle, Washington
Robert S.B. Clark, MD
Professor and Vice Chair, Critical Care Medicine, University
of Pittsburgh School of Medicine; Associate Director, Safar
Center for Resuscitation Research, University of Pittsburgh,
Pittsburgh, Pennsylvania
Bradley P. Fuhrman, MD, FAAP, MCCM
Professor of Pediatrics in Medical Education,
Clinical Educator and Gold College Mentor, Paul L. Foster
School of Medicine, Texas Tech University HSC El Paso,
El Paso, Texas
SIXTH EDITION
ALEXANDRE T. ROTTA, MD, FCCM
Division Chief, Pediatric Critical Care Medicine Duke
Children’s Hospital; Professor of Pediatrics; Duke University
School of Medicine, Durham, North Carolina
Sapna Ravi Kudchadkar, MD, PhD, FCCM
Associate Professor, Anesthesiology and Critical Care
Medicine, Pediatrics, and Physical Medicine and
Rehabilitation, Charlotte R. Bloomberg Children’s Center,
Johns Hopkins University School of Medicine, Baltimore,
Maryland
Monica Relvas, MD, FAAP, FCCM, MSHA
Medical Director, Pediatric Critical Care Medicine,
Covenant Children’s Hospital, Associate Clinical Professor,
Texas Tech University, Lubbock, Texas
Joseph D. Tobias, MD
Chair, Department of Anesthesiology and Pain Medicine,
Nationwide Children’s Hospital; Professor of Anesthesiology
and Pediatrics, The Ohio State University, Columbus, Ohio
Elsevier
1600 John F. Kennedy Blvd.
Ste 1600
Philadelphia, PA 19103-2899

FUHRMAN AND ZIMMERMAN’S PEDIATRIC CRITICAL CARE,

SIXTH EDITION  ISBN: 978-0-323-67269-6

Copyright © 2022 by Elsevier, Inc. All rights reserved.

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This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).

Notice

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Publishing Services Manager: Catherine Jackson
Senior Project Manager/Specialist: Carrie Stetz
Design Direction: Patrick Ferguson

Printed in Canada

Last digit is the print number: 9 8 7 6 5 4 3 2 1

Contributors

Isaac Josh Abecassis, MD Ben D. Albert, MD

Resident Physician Program Director, Critical Care Medicine Fellowship
Department of Neurological Surgery Department of Anesthesiology, Critical Care, and Pain Medicine
University of Washington Boston Children’s Hospital
Seattle, Washington Boston, Massachusetts

Jayani Abeysekera, MD, FRCP Alicia Alcamo, MD, MPH

Assistant Professor Assistant Professor of Critical Care and Pediatrics
Department of Pediatrics Department of Anesthesiology and Critical Care Medicine
Division of Cardiology University of Pennsylvania Perelman School of Medicine
Dalhousie University/IWK Health Centre Children’s Hospital of Philadelphia
Halifax, Nova Scotia, Canada Philadelphia, Pennsylvania

P. David Adelson, MD, FAAP, FACS, FAANS Matthew N. Alder, MD, PhD
Diane and Bruce Halle Chair of Children’s Neurosciences Assistant Professor
Director, Barrow Neurological Institute at Phoenix Children’s Critical Care Medicine
Hospital Cincinnati Children’s Hospital Medical Center
Professor, Department of Child Health Cincinnati, Ohio
University of Arizona College of Medicine;
Professor, Department of Neurosurgery Omar Alibrahim, MD, FAAP
Mayo Clinic Chief, Pediatric Critical Care Division
Phoenix, Arizona John R. Oishei Children’s Hospital
Associate Professor of Pediatrics
Rachel S. Agbeko, FRCPCH, PhD Jacob’s School of Medicine
Consultant University of Buffalo
Paediatric Intensive Care Unit Buffalo, New York
Great North Children’s Hospital
Newcastle upon Tyne Hospitals NHS Trust Veerajalandhar Allareddy, MBBS, MBA
Newcastle upon Tyne, United Kingdom Section Chief, Pediatric Cardiac Intensive Care
Duke University Medical Center
Michael S.D. Agus, MD Professor of Pediatrics
Chief of Medical Critical Care Duke University School of Medicine
Department of Pediatrics Durham, North Carolina
Division of Medical Critical Care
Boston Children’s Hospital Melvin C. Almodovar, MD
Boston, Massachusetts The George E. Batchelor Chair in Pediatric Cardiology
Chief, Pediatric Cardiology
Mubbasheer Ahmed, MD University of Miami Miller School of Medicine;
Cardiac Intensive Care Unit Director, Children’s Heart Center
Texas Medical Center Director, Cardiac Intensive Care
Texas Children’s Hospital Hotz Children’s Hospital, Jackson Health System
Houston, Texas Miami, Florida

Alireza Akhondi-Asl, PhD Alexandra Aminoff, MD

Departments of Anesthesiology, Critical Care, and Pain Acting Assistant Professor
Medicine Department of Pediatric Rheumatology
Division of Critical Care Seattle Children’s Hospital
Boston Children’s Hospital Seattle, Washington
Boston, Massachusetts

v
vi Contributors

Catherine Amlie-Lefond, MD Adnan M. Bakar, MD

Professor Assistant Professor of Pediatrics
Department of Neurology Section Head, Pediatric Cardiac Critical Care
University of Washington Cohen Children’s Medical Center of Hofstra/Northwell
Seattle, Washington New Hyde Park, New York

Rajesh Aneja, MD Katherine Banker, MD

Clinical Chief, Division of Pediatric Critical Care Medicine Clinical Assistant Professor
Medical Director, Pediatric Intensive Care Unit Department of Pediatrics, Critical Care
Children’s Hospital of Pittsburgh of UPMC; Seattle Children’s Hospital
Professor Seattle, Washington
Department of Critical Care Medicine and Pediatrics
University of Pittsburgh School of Medicine Piers C.A. Barker, MD
Pittsburgh, Pennsylvania Professor of Pediatrics and Obstetrics/Gynecology
Department of Pediatrics
Abigail Apple, ARNP Duke University School of Medicine
Pediatric Critical Care Durham, North Carolina
Seattle Children’s Hospital
Seattle, Washington Lee M. Bass, MD
Associate Professor of Pediatrics
Andrew C. Argent, MD Departments of Gastroenterology, Hepatology & Nutrition
Professor Ann & Robert H. Lurie Children’s Hospital of Chicago
School of Child and Adolescent Health Northwestern University Feinberg School of Medicine
University of Cape Town; Chicago, Illinois
Medical Director
Paediatric Intensive Care Rajit K. Basu, MD, MS, FCCM
Red Cross War Memorial Children’s Hospital Associate Professor of Pediatrics
Cape Town, South Africa Emory School of Medicine;
Research Director
Joan C. Arvedson, PhD Division of Pediatric Critical Care Medicine
Program Coordinator, Feeding & Swallowing Services Children’s Healthcare of Atlanta
Speech Pathology and Audiology Atlanta, Georgia
Children’s Hospital of Wisconsin;
Clinical Professor Hülya Bayir, MD
Department of Pediatrics Safar Center for Resuscitation Research
Medical College of Wisconsin Department of Critical Care Medicine
Milwaukee, Wisconsin University of Pittsburgh School of Medicine
Children’s Hospital of Pittsburgh of UPMC
François Aspesberro, MD Pittsburgh, Pennsylvania
Pediatric Cardiothoracic ICU
Miller Children’s & Women’s Hospital Long Beach Lance B. Becker, MD
Long Beach, California Chair, Emergency Medicine
Donald and Barbara Zucker School of Medicine at
Nir Atlas, MD Hofstra/Northwell
Clinical Fellow Hempstead, New York
Division of Pediatric Critical Care
Children’s Healthcare of Atlanta–Egleston Jamie L. Bell, MD
Emory University School of Medicine Assistant Professor of Pediatrics
Atlanta, Georgia Department of Pediatrics
Children’s Hospital of Michigan
John E. Baatz, PhD Wayne State University School of Medicine
Professor Detroit, Michigan
Department of Pediatrics
Medical University of South Carolina Michael J. Bell, MD
Charleston, South Carolina Chief, Pediatric Critical Care Medicine
Department of Pediatrics
Harris P. Baden, MD Children’s National Medical Center
Professor and Chief Washington, DC
Pediatric Cardiac Critical Care
University of Washington
Seattle Children’s Hospital
Seattle, Washington
 Contributors vii

Melania M. Bembea, MD, MPH, PhD Naomi B. Bishop, MD

Associate Professor Assistant Professor
Department of Anesthesiology and Critical Care Medicine Department of Pediatric Critical Care Medicine
Johns Hopkins University School of Medicine Weill Cornell Medical College
Baltimore, Maryland New York, New York

M.A. Bender, MD, PhD Julie Blatt, MD

Director, Sickle Cell and Hemoglobinopathy Program Professor
Odessa Brown Children’s Clinic; Pediatric Hematology Oncology
Associate Professor University of North Carolina
Department of Pediatrics Chapel Hill, North Carolina
University of Washington
Seattle, Washington Lauren Bodilly, MD
Critical Care Fellow
Alexis L. Benscoter, DO Department of Pediatric Critical Care
Assistant Professor of Clinical Pediatrics Cincinnati Children’s Hospital
University of Cincinnati College of Medicine; Cincinnati, Ohio
Department of Cardiac Critical Care Medicine
Division of Cardiology Robert H. Bonow, MD
Cincinnati Children’s Hospital Medical Center Resident Physician
Cincinnati, Ohio Department of Neurological Surgery
University of Washington
Wade W. Benton, PharmD Seattle, Washington
Chief Development Officer
Eicos Sciences, Inc. E. Alexis Bragg, MD
San Mateo, California Assistant Professor of Anesthesiology and Pediatrics
Department of Anesthesia and Critical Care Medicine
Robert A. Berg, MD Children’s Hospital Los Angeles
Professor Keck School of Medicine–University of Southern California
Departments of Anesthesiology, Critical Care Medicine, Los Angeles, California
and Pediatrics
University of Pennsylvania Perelman School of Medicine; Barbara W. Brandom, MD
Division Chief, Critical Care Medicine Retired Professor
Departments of Anesthesiology and Critical Care Medicine Department of Anesthesiology
Children’s Hospital of Philadelphia University of Pittsburgh;
Philadelphia, Pennsylvania Retired Director
North American MH Registry of MHAUS
Emily Berkman, MD Pittsburgh, Pennsylvania
Assistant Professor
Departments of Pediatrics and Bioethics and Humanities Richard J. Brilli, MD
University of Washington School of Medicine; Chief Medical Officer
Division of Pediatric Critical Care Hospital Administration
Department of Pediatric Bioethics Nationwide Children’s Hospital;
Treuman Katz Center for Pediatric Bioethics Professor
Seattle Children’s Hospital Department of Pediatrics
Seattle, Washington Division of Critical Care Medicine
The Ohio State University College of Medicine
Carol Berkowitz, MD Columbus, Ohio
Chief, Division of General Pediatrics
Department of Pediatrics Thomas V. Brogan, MD
Harbor-UCLA Medical Center Professor
Torrance, California; Department of Pediatrics
Distinguished Professor of Pediatrics University of Washington School of Medicine
David Geffen School of Medicine at UCLA Seattle, Washington
Los Angeles, California
Ronald A. Bronicki, MD, FCCM, FACC
Katherine V. Biagas, MD Professor
Associate Professor Departments of Critical Care Medicine and Cardiology
Department of Pediatrics Texas Children’s Hospital and Baylor College of Medicine
Vice Chairman for Faculty Development Houston, Texas
Stony Brook Children’s and the Renaissance School of Medicine
Stony Brook, New York
viii Contributors

Samuel R. Browd, MD, PhD, FAANS, FAAP Michael P. Carboni, MD

Professor Medical Director, Pediatric Heart Failure & Transplant
Department of Neurological Surgery Department of Pediatrics
Seattle Children’s Hospital Duke Children’s Hospital
University of Washington Durham, North Carolina
Seattle, Washington
Joseph A. Carcillo, MD
Timothy E. Bunchman, MD Professor of Critical Care Medicine and Pediatrics
Professor and Director, Pediatric Nephrology Children’s Hospital of Pittsburgh
Children’s Hospital of Richmond University of Pittsburgh School of Medicine
Virginia Commonwealth University School of Medicine Pittsburgh, Pennsylvania
Richmond, Virginia
Antonio Cassara, MBChB
Jeffrey P. Burns, MD, MPH Associate Professor
Chief and Endowed Shapiro Chair of Critical Care Medicine Department of Anesthesia
Chair, Governance Committee of the Intensive Care Units Ruby Memorial Hospital
Boston Children’s Hospital Morgantown, West Virginia
Professor of Anesthesia
Harvard Medical School Nina Censoplano, MD
Boston, Massachusetts Attending physician
Pediatric Critical Care Medicine
David F. Butler, MD INOVA Fairfax Medical Center
Fellow Falls Church, Virginia
Department of Pediatrics
Division of Critical Care Victoria Chadwick, PharmD, BCCCP
Seattle Children’s Hospital Critical Care Pharmacist
Seattle, Washington Seattle Children’s Hospital
Seattle, Washington
Derya Caglar, MD
Fellowship Director, Pediatric Emergency Medicine Reid C. Chamberlain, MD
Associate Professor, Pediatrics Pediatric Cardiology Fellow
University of Washington School of Medicine Department of Pediatrics
Attending Physician Duke University Hospital
Division of Pediatric Emergency Medicine Durham, North Carolina
Seattle Children’s Hospital
Seattle, Washington Anny Chan, PharmD
Hematopoietic Stem Cell Transplant Clinical Pharmacist
Michael W. Camitta, MD Seattle Children’s Hospital
Associate Professor of Pediatrics Seattle, Washington
Department of Pediatrics
Duke University School of Medicine John R. Charpie, MD, PhD
Durham, North Carolina Amnon Rosenthal Professor & Director of Pediatric Cardiology
University of Michigan Medical School
M. Jay Campbell, MD, MHA Co-Director, University of Michigan Congenital Heart Center
Associate Professor of Pediatrics C.S. Mott Children’s Hospital
Department of Pediatrics Michigan Medicine
Duke University School of Medicine Ann Arbor, Michigan
Durham, North Carolina
Ira M. Cheifetz, MD
Sally Campbell, MBBS(Hons), FRACP, FRCPA Professor
Paediatric Haematologist Departments of Pediatrics and Anesthesiology
Royal Children’s Hospital Duke University Medical Center
Melbourne, Australia Durham, North Carolina

Karel D. Capek, MD Saurabh Chiwane, MD

Fellow Assistant Professor
Acute Burn, Critical Care, and Reconstruction Department of Pediatrics
Shriners Hospitals for Children Saint Louis University
Galveston and the University of Texas Medical Branch St. Louis, Missouri
Galveston, Texas
 Contributors ix

Robert H. Chun, MD Craig M. Coopersmith, MD

Associate Professor Professor
Department of Pediatric Otolaryngology Department of Surgery
Medical College of Wisconsin Emory University
Milwaukee, Wisconsin Atlanta, Georgia

Jeff Clark, MD Seth J. Corey, MD, MPH

Staff Intensivist Professor
Pediatric Critical Care Medicine Departments of Pediatrics and Molecular Medicine
Vice Chair of Pediatrics Cleveland Clinic
Ascension St. John Children’s Hospital Cleveland, Ohio
Detroit, Michigan
Mary K. Dahmer, PhD
Jonna D. Clark, MD Associate Professor
Associate Professor Department of Pediatrics
Departments of Pediatrics and Critical Care Medicine Division of Critical Care
University of Washington; University of Michigan Medical School
Faculty Ann Arbor, Michigan
Treuman Katz Center for Pediatric Bioethics
Seattle Children’s Hospital Heidi J. Dalton, MD, MCCM, FELSO
Seattle, Washington Director of ECMO Program Development and Research
INOVA Fairfax Medical Center
Robert S.B. Clark, MD Falls Church, Virginia;
Professor and Vice Chair Professor of Pediatrics
Critical Care Medicine Virginia Commonwealth University
University of Pittsburgh School of Medicine; Richmond, Virginia;
Associate Director, Safar Center for Resuscitation Research Professor of Clinical Surgery
University of Pittsburgh George Washington University
Pittsburgh, Pennsylvania Washington, DC

April Clawson, MD Rahul C. Damania, MD, FAAP

Fellow Clinical Fellow
Pediatric Emergency Medicine Division of Pediatric Critical Care
University of Arkansas Medical Center Children’s Healthcare of Atlanta–Egleston
Little Rock, Arkansas Emory University School of Medicine
Atlanta, Georgia
Jason A. Clayton, MD, PhD
Assistant Professor Mihaela A. Damian, MD, MPH
Department of Pediatrics Clinical Assistant Professor
Rainbow Babies & Children’s Hospital Department of Pediatrics
Cleveland, Ohio Stanford University
Palo Alto, California
Thomas Conlon, MD
Assistant Professor Lauren Dartois, PharmD
Department of Pediatric Critical Care Medicine Critical Care Clinical Pharmacist
The Children’s Hospital of Philadelphia Seattle Children’s Hospital
Philadelphia, Pennsylvania Seattle, Washington

Carol Conrad, MD Peter J. Davis, MD, FAAP

Associate Professor Professor
Department of Pediatrics Departments of Anesthesiology and Pediatrics
Stanford University University of Pittsburgh School of Medicine;
Palo Alto, California Anesthesiologist-in-Chief
Department of Anesthesiology
Edward E. Conway Jr, MD, MS Children’s Hospital of Pittsburgh of UPMC
Chairman and Pediatrician-in-Chief Pittsburgh, Pennsylvania
Milton and Bernice Stern Department of Pediatrics
Beth Israel Medical Center;
Professor of Pediatrics
Icahn School of Medicine at Mount Sinai
New York, New York
x Contributors

Leslie A. Dervan, MD Allan Doctor, MD

Assistant Professor Professor of Pediatrics (Critical Care)
Department of Pediatrics Director, Center for Blood Oxygen Transport and Hemostasis
Seattle Children’s Hospital University of Maryland School of Medicine
University of Washington School of Medicine Baltimore, Maryland
Seattle, Washington
John J. Downes, MD
Clifford S. Deutschman, MS, MD, MCCM Professor Emeritus of Anesthesiology and Critical Care, and
Vice Chair, Research Pediatrics
Department of Pediatrics University of Pennsylvania Perelman School of Medicine
Professor of Pediatrics and Molecular Medicine Chair Emeritus of Anesthesiology and Critical Care Medicine
Donald and Barbara Zucker School of Medicine at Children’s Hospital of Philadelphia
Hofstra/Northwell Philadelphia, Pennsylvania
Hempstead, New York;
Cohen Children’s Medical Center Christine Duncan, MD
New York, New York; Associate Clinical Director of Pediatric HSCT
Professor, Elmezzi Graduate School of Molecular Medicine Senior Physician
Professor, Feinstein Institutes for Medical Research Dana Farber/Boston Children’s Cancer and Blood Disorders
Manhasset, New York; Center;
Emeritus Professor of Anesthesiology & Critical Care and Assistant Professor of Pediatrics
Surgery Harvard Medical School
Perelman School of Medicine at the University of Pennsylvania Boston, Massachusetts
Philadelphia, Pennsylvania
Christopher M. Edwards, MD
Cameron Dezfulian, MD, FAHA Assistant Professor
Director, Adult Congenital Heart Disease ICU Department of Anesthesiology
Critical Care Medicine Section University of Florida College of Medicine
Texas Children’s Hospital; Gainesville, Florida
Senior Faculty
Baylor College of Medicine Lauren R. Edwards, MD
Houston, Texas Assistant Professor
Pediatric Critical Care
André A.S. Dick, MD, MPH University of Arkansas for Medical Sciences/Arkansas Children’s
Associate Professor of Surgery Hospital
ASTS Transplant Fellowship Director Little Rock, Arkansas
Surgical Director, Pediatric Kidney Transplant
Department of Surgery Chinyere Egbuta, MD
Division of Transplantation Instructor
Seattle Children’s Hospital Department of Anesthesia
University of Washington School of Medicine Harvard Medical School;
Seattle, Washington Associate Professor
Anesthesia and Critical Care Medicine
Douglas S. Diekema, MD, MPH Boston Children’s Hospital
Professor Boston, Massachusetts
Department of Pediatrics
University of Washington; Howard Eigen, MD
Director of Education Professor of Pediatrics, Retired
Treuman Katz Center for Pediatric Bioethics Department of Pediatrics
Seattle Children’s Research Institute Indiana University School of Medicine
Seattle, Washington Indianapolis, Indiana

Michael Dingeldein, MD Hannah Laure Elfassy, MD, FRCP(c)

Trauma Medical Director Chief
Rainbow Babies & Children’s Hospital Department of Allergy and Clinical Immunology
Assistant Professor of Surgery Sacré Coeur Hospital
Case Western Reserve University Montreal, Quebec, Canada
Cleveland, Ohio

Alison M. Ellis, MD, MBA
Assistant Professor
Anesthesia and Perioperative Medicine
Charleston, South Carolina
Idris V.R. Evans, MD
Assistant Professor
Department of Critical Care Medicine
University of Pittsburgh
Pittsburgh, Pennsylvania
Reid W.D. Farris, MD
Associate Professor
Department of Pediatrics
Division of Critical Care Medicine
University of Washington
Seattle, Washington
Jeffrey R. Fineman, MD
Professor
Department of Pediatrics
University of California, San Francisco
San Francisco, California
Ericka L. Fink, MD
Associate Professor of Critical Care Medicine
University of Pittsburgh School of Medicine
Children’s Hospital of Pittsburgh of UPMC;
Associate Director
Safar Center for Resuscitation Research
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
Frank A. Fish, MD
Professor
Department of Pediatrics
Vanderbilt Medical Center
Nashville, Tennessee
Tamara N. Fitzgerald, MD, PhD
Assistant Professor
Department of Surgery
Duke University
Durham, North Carolina
Gregory A. Fleming, MD, MSCI, FSCAI
Associate Professor
Department of Pediatrics
Duke University
Durham, North Carolina
Saul Flores, MD
Assistant Professor
Pediatrics/Critical Care
Baylor College of Medicine;
Attending Physician
Texas Children’s Hospital
Houston, Texas
Contributors xi
Joseph T. Flynn, MD
Chief, Division of Nephrology
Department of Pediatrics
Seattle Children’s Hospital;
Professor
Department of Pediatrics
University of Washington School of Medicine
Seattle, Washington
Michael L. Forbes, MD, FCCM
Professor and Associate Chair
Department of Pediatrics
Northeast Ohio Medical University;
Director, Critical Care Research & Outcomes Analysis
Akron Children’s Hospital
Akron, Ohio
Joseph M. Forbess, MD
Department of Surgery
Northwestern University Feinberg School of Medicine
Chicago, Illinois
Deborah E. Franzon, MD
Clinical Professor
Department of Pediatric Medicine
Division of Critical Care Medicine
University of California, San Francisco
San Francisco, California
W. Joshua Frazier, MD
Assistant Professor of Pediatrics
Critical Care Medicine
Nationwide Children’s Hospital
Columbus, Ohio
Bradley P. Fuhrman, MD, FAAP, MCCM
Professor of Pediatrics in Medical Education
Clinical Educator and Gold College Mentor
Paul L. Foster School of Medicine
Texas Tech University HSC El Paso
El Paso, Texas
Richard M. Ginther Jr, MBA, BS
Pediatric Perfusionist
Pediatric Cardiothoracic Surgery
UT Southwestern Medical Center
Dallas, Texas
Nicole Glaser, MD
Professor
Department of Pediatrics
Section of Endocrinology and Diabetes
University of California, Davis
Sacramento, California
Ana Lia Graciano, MD, FCCM
Professor of Pediatrics
Medical Director CICU
Pediatric Critical Care Medicine
University of Maryland Children’s Hospital
Baltimore, Maryland
xii Contributors

Megan M. Gray, MD Cary O. Harding, MD

Assistant Professor of Pediatrics Professor
Department of Pediatrics Department of Molecular and Medical Genetics
Division of Neonatology Oregon Health & Science University
Fellowship Program Director for Neonatal-Perinatal Medicine Portland, Oregon
Seattle Children’s Hospital
University of Washington School of Medicine Mary E. Hartman, MD, MPH
Seattle, Washington Associate Professor
Department of Pediatrics
Kristin C. Greathouse, CPNP-AC, PhD Washington University in St. Louis
Heart Center St. Louis, Missouri
University of Minnesota Masonic Children’s Hospital
Minneapolis, Minnesota Silvia M. Hartmann, MD
Assistant Professor
Bruce M. Greenwald, MD, FAAP, FCCM Critical Care Medicine
Professor of Clinical Pediatrics Seattle Children’s Hospital
Executive Vice-Chair, Department of Pediatrics Seattle, Washington
Division of Pediatric Critical Care Medicine
Weill Cornell Medical College Kevin M. Havlin, MD
New York, New York Assistant Professor
Department of Pediatrics
Matthew M. Grinsell, MD, PhD Division of Pediatric Critical Care
Associate Professor University of Louisville
Department of Pediatrics Louisville, Kentucky
University of Utah
Salt Lake City, Utah Kristen Hayward, MD
Associate Professor
Jocelyn R. Grunwell, MD Department of Pediatrics
Assistant Professor Division of Rheumatology
Department of Pediatrics Seattle Children’s Hospital
Division of Critical Care Medicine University of Washington School of Medicine
Emory University/Children’s Healthcare of Atlanta Seattle, Washington
Atlanta, Georgia
Patrick J. Healey, MD
Björn Gunnarsson, MD Professor
Department of Research Department of Surgery
Norwegian Air Ambulance Foundation University of Washington School of Medicine
Drøbak, Norway Division Chief, Pediatric Transplant Surgery
SAR Helicopter Seattle Children’s Hospital
Ørland Main Air Station, Norway Seattle, Washington

Marla Guzman, MD Christopher M.B. Heard, MBChB, FRCA

Fellow Clinical Professor
Pediatric Rheumatology Department of Anesthesiology
Cohen Children’s Medical Center-Zucker School of Medicine at Clinical Professor
Hofstra/Northwell Division of Pediatric Critical Care
New Hyde Park, New York Oishei Children’s Hospital
Buffalo, New York
Timothy Hahn, MD
Fellow Julia A. Heneghan, MD
Department of Pediatrics Assistant Professor
Penn State Children’s Hospital Pediatric Critical Care
Hershey, Pennsylvania University of Minnesota Masonic Children’s Hospital
Minneapolis, Minnesota
Mark W. Hall, MD
Chief, Division of Critical Care Medicine David N. Herndon, MD
Department of Pediatrics Editor, Burn Care and Research
Nationwide Children’s Hospital American Burn Association
Columbus, Ohio Chicago, Illinois
 Contributors xiii

Lynn J. Hernan, MD Laura Marie Ibsen, MD

Associate Professor of Pediatrics Professor of Pediatrics
Pediatric Clerkship Director Division Chief, Pediatric Critical Care
Texas Tech University HSC El Paso Department of Pediatrics
Paul L. Foster School of Medicine Oregon Health and Sciences University
El Paso, Texas Portland, Oregon

Kevin D. Hill, MD, MSCI Hanneke Ijsselstijn, MD, PhD

Associate Professor Associate Professor of Pediatrics
Department of Pediatrics Department of Pediatric Surgery and Intensive Care
Duke University Medical Center Erasmus Medical Center, Sophia Children’s Hospital
Durham, North Carolina Rotterdam, The Netherlands

Julien I. Hoffman† Travis C. Jackson, PhD

Professor (Emeritus) Associate Professor of Molecular Pharmacology & Physiology
Pediatrics University of South Florida
University of California, San Francisco Morsani College of Medicine
San Francisco, California USF Health Heart Institute
Tampa, Florida
Paula Holinski, MD, FRCPC
Clinical Assistant Professor of Anesthesiology Shelina M. Jamal, MD
University of Alberta Clinical Assistant Professor
Pediatric Anesthesia and Pediatric Cardiac Intensive Care Pediatric Critical Care
Stollery Children’s Hospital Alberta Children’s Hospital
Edmonton, Alberta, Canada Calgary, Alberta, Canada

Sue J. Hong, MD Prashant Joshi, MD

Assistant Professor Associate Professor
Departments of Pediatrics and Neurology Department of Pediatrics
Northwestern University Texas Tech University Health Sciences Center El Paso
Lurie Children’s Hospital of Chicago El Paso, Texas
Chicago, Illinois
Emily L. Joyce, MD
Simon Horslen, MB ChB Assistant Professor
Professor Department of Pediatrics, Division of Nephrology
Department of Pediatrics UH Rainbow Babies and Children’s Hospital
University of Washington School of Medicine; Case Western Reserve University School of Medicine
Medical Director of Solid Organ Transplantation Cleveland, Ohio
Department of Gastroenterology, Hepatology & Nutrition
Seattle Children’s Hospital Tom Kallay, MD
Seattle, Washington Chief, Division of Pediatric Critical Care Medicine
Director, Simulation and Educational Resource Center for
Aparna Hoskote, MBBS, DCH, MRCP, MD Improved Patient Safety and Outcomes
Consultant in Cardiac Intensive Care Harbor-UCLA Medical Center
Honorary Senior Lecturer Torrance, California;
UCL Great Ormond Street Institute of Child Health Associate Professor of Clinical Pediatrics
Great Ormond Street Hospital for Children David Geffen School of Medicine
NHS Foundation Trust Los Angeles, California
London, United Kingdom
Pradip P. Kamat, MD
Justin C. Hotz, BSRT, RRT-NPS Medical Director, Sedation
Senior Research Associate Children’s Healthcare of Atlanta
Department of Anesthesia and Critical Care Medicine Atlanta, Georgia
Children’s Hospital Los Angeles
Los Angeles, California Jason M. Kane, MD, MS, FAAP, FCCM
Associate Professor of Pediatrics
Department of Pediatric Critical Care Medicine
University of Chicago Comer Children’s Hospital
Chicago, Illinois
†
Deceased.
xiv Contributors

Prince J. Kannankeril, MD Christa Jefferis Kirk, PharmD, BCCP

Professor Heart Center Clinical Pharmacy Specialist
Department of Pediatrics Seattle Children’s Hospital;
Vanderbilt Children’s Hospital Clinical Associate Professor
Nashville, Tennessee School of Pharmacy
University of Washington
Oliver Karam, MD, PhD Seattle, Washington
Division Chief
John J. Mickell Endowed Associate Professor of Pediatrics Sonya Kirmani, MD
Department of Pediatrics Medical Instructor
Children’s Hospital of Richmond at VCU Department of Pediatrics
Richmond, Virginia Duke University
Durham, North Carolina
Katherine L. Kenningham, MD
Fellow, Neonatal-Perinatal Medicine Ruth Kleinpell, PhD, RN, APRN-BC
Department of Pediatrics Director, Center for Clinical Research and Scholarship
Division of Neonatology Assistant Dean for Clinical Scholarship
Seattle Children’s Hospital Vanderbilt University School of Nursing
University of Washington School of Medicine Nashville, Tennessee
Seattle, Washington
Patrick M. Kochanek, MD, MCCM
Hedieh Khalatbari, MD, MBA Ake N. Grenvik Professor in Critical Care Medicine
Assistant Professor of Pediatric Radiology Department of Critical Care Medicine
Department of Radiology University of Pittsburgh School of Medicine
Seattle Children’s Hospital and University of Washington Pittsburgh, Pennsylvania
Seattle, Washington
Keith C. Kocis, MD, MS
Robinder G. Khemani, MD, MsCI Director, Pediatric Cardiac ICU
Associate Director of Research Co-Director, Pediatric ECLS
Department of Anesthesiology and Critical Care Medicine Inova Children’s Hospital
Children’s Hospital Los Angeles; Inova Heart and Vascular Institute;
Associate Professor of Pediatrics Professor of Pediatrics
Keck School of Medicine VCU School of Medicine Inova Campus
University of Southern California Falls Church, Virginia
Los Angeles, California
Samuel A. Kocoshis, MD
Elizabeth Y. Killien, MD, MPH Professor
Acting Assistant Professor Department of Pediatrics
Department of Pediatrics University of Cincinnati College of Medicine;
Division of Pediatric Critical Care Medicine Medical Director, Intestinal Transplantation and Intestinal Care
Seattle Children’s Hospital Center
University of Washington Department of Gastroenterology, Hepatology, and Nutrition
Seattle, Washington Cincinnati Children’s Hospital Medical Center
Cincinnati, Ohio
Yun Kim, MS, OTR/L
Pediatric Rehabilitation Clinical Specialist Ildiko H. Koves, MD, FRACP
Department of Physical Medicine and Rehabilitation Associate Professor
Johns Hopkins Children’s Center Department of Endocrinology and Diabetes
Baltimore, Maryland Seattle Children’s Hospital
Seattle, Washington
Jenny Kingsley, MD
Fellow Sapna R. Kudchadkar, MD, PhD
Pediatric Critical Care Medicine Associate Professor of Anesthesiology and Critical Care
Treuman Katz Center for Pediatric Bioethics Medicine, Pediatrics, and Physical Medicine and
Seattle Children’s Hospital Rehabilitation
Seattle, Washington Charlotte R. Bloomberg Children’s Center
Johns Hopkins University School of Medicine
Baltimore, Maryland
 Contributors xv

Thomas J. Kulik, MD John C. Lin, MD

Senior Associate in Cardiology Associate Professor
Department of Cardiology Department of Pediatrics
Boston Children’s Hospital Washington University School of Medicine
Associate Professor of Pediatrics St. Louis, Missouri
Harvard Medical School
Boston, Massachusetts Aline Maddux, MD
Assistant Professor of Pediatrics
Jacques Lacroix, MD Department of Pediatric Critical Care
Professor University of Colorado Anschutz Medical Campus
Department of Pediatrics Aurora, Colorado
Sainte-Justine Hospital
Montreal, Quebec, Canada Matthew P. Malone, MD
Assistant Professor
Ruth Lebet, PhD, RN, PCNS-BC, CCNS-P Pediatric Critical Care
Nurse Scientist University of Arkansas for Medical Sciences/Arkansas Children’s
Center for Pediatric Nursing Research & Evidence-Based Hospital
Practice; Little Rock, Arkansas
Program Director, Pediatric & Neonatal CNS Programs
University of Pennsylvania School of Nursing Mioara Manole, MD
Philadelphia, Pennsylvania Associate Professor of Pediatrics
University of Pittsburgh School of Medicine
Amy Lee, MD Children’s Hospital of Pittsburgh of UPMC;
Associate Professor Associate Director
Department of Neurological Surgery Safar Center for Resuscitation Research
University of Washington University of Pittsburgh Medical Center
Seattle, Washington Pittsburgh, Pennsylvania

Hallie Lenker, PT, DPT Anne Marsh, MD

Pediatric Rehabilitation Team Coordinator Associate Professor of Pediatrics
Department of Physical Medicine and Rehabilitation Department of Hematology/Oncology & Bone Marrow
Johns Hopkins Children’s Center Transplant
Baltimore, Maryland University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin
Daniel L. Levin, MD
Professor Emeritus Richard J. Martin, MBBS
Departments of Pediatrics and Anesthesia Professor
Children’s Hospital at Dartmouth Departments of Pediatrics, Reproductive Biology, and Physiology
Lebanon, New Hampshire & Biophysics
Case Western Reserve University School of Medicine;
Emily R. Levy, MD Drusinsky-Fanaroff Professor and Director of Neonatal Research
Assistant Professor Pediatrics/Neonatology
Department of Pediatric and Adolescent Medicine Rainbow Babies & Children’s Hospital
Divisions of Pediatric Critical Care Medicine and Pediatric Cleveland, Ohio
Infectious Diseases
Mayo Clinic Mudit Mathur, MD, MBA, FAAP, FCCM, CPPS
Rochester, Minnesota Director, Pediatric Critical Care
Director, Patient Safety and Risk Management
Mithya Lewis-Newby, MD, MPH Kaiser Permanente Fontana Medical Center;
Associate Professor Associate Professor
Departments of Pediatrics and Bioethics and Humanities Department of Clinical Science
University of Washington School of Medicine; Kaiser Permanente Bernard J. Tyson School of Medicine
Division of Pediatric Cardiac Critical Care Pasadena, California
Treuman Katz Center for Pediatric Bioethics
Seattle Children’s Hospital Jennifer McArthur, MD
Seattle, Washington Associate Member
St. Jude’s Research Hospital
Pediatric Critical Care
Memphis, Tennessee;
Adjunct Associate Professor of Pediatrics
Medical College of Wisconsin
Milwaukee, Wisconsin
xvi Contributors

Christine McCusker, MD Ryan W. Morgan, MD, MTR

Associate Professor Assistant Professor of Anesthesia, Critical Care, and Pediatrics
Department of Pediatrics Department of Anesthesiology and Critical Care Medicine
McGill University; University of Pennsylvania
Director Philadelphia, Pennsylvania
Division of Allergy, Immunology and Dermatology
Montreal Children’s Hospital Peter F. Morgenstern, MD
Montreal, Quebec Assistant Professor
Department of Neurosurgery
Ruth A. McDonald, MD Icahn School of Medicine at Mount Sinai
Professor of Pediatrics New York, New York
Division of Nephrology
University of Washington Michael J. Morowitz, MD
Chief Medical Officer, Hospital Operations Associate Professor
Seattle Children’s Hospital Pediatric General and Thoracic Surgery
Seattle, Washington UPMC Children’s Hospital of Pittsburgh
Pittsburgh, Pennsylvania
Nilesh M. Mehta, MD, FASPEN
Professor of Anesthesia Wynne Morrison, MD, MBE
Harvard Medical School; Ingerman Endowed Chair in Palliative Care
Director of Quality and Outcomes Attending Physician, Critical Care and Palliative Care
Director of Critical Care Nutrition Children’s Hospital of Philadelphia
Associate Medical Director Associate Professor of Anesthesiology and Critical Care
Division of Critical Care Medicine Perelman School of Medicine at the University of Pennsylvania
Chair, Critical Care Nutrition and Metabolism Philadelphia, Pennsylvania
Department of Anesthesiology, Critical Care, and Pain Medicine
Boston Children’s Hospital Raj Munshi, MD
Boston, Massachusetts; Associate Professor
Past President Department of Pediatrics
American Society for Parenteral & Enteral Nutrition Seattle Children’s Hospital
Seattle, Washington
Ann J. Melvin, MD, MPH
Professor Jennifer A. Muszynski, MD, MPH
Department of Pediatrics Assistant Professor of Pediatrics
Division of Infectious Disease Critical Care Medicine
Seattle Children’s Hospital Nationwide Children’s Hospital
University of Washington Columbus, Ohio
Seattle, Washington
Vinay M. Nadkarni, MD
Shina Menon, MD Professor
Assistant Professor Departments of Anesthesiology, Critical Care, and Pediatrics
Department of Pediatrics University of Pennsylvania Perelman School of Medicine
Division of Nephrology Philadelphia, Pennsylvania
Seattle Children’s Hospital
University of Washington Jessica A. Naiditch, MD
Seattle, Washington Trauma Medical Director
Dell Children’s Medical Center of Central Texas;
Paul Monagle, MBBS, MD Assistant Professor of Surgery
Professor Department of Surgery & Perioperative Care
Department of Paediatrics Dell Medical School, University of Texas Austin;
University of Melbourne; Pediatric Surgeon
Haematologist Austin Pediatric Surgery
Royal Children’s Hospital; Austin, Texas
Group Leader
Haematology Research Thomas A. Nakagawa, MD, FAAP, FCCM
Murdoch Children’s Research Institute Professor
Melbourne, Victoria, Australia Department of Pediatrics
Division of Critical Care Medicine
University of Florida College of Medicine;
Medical Director, Pediatric Intensive Care
Wolfson Children’s Hospital
Jacksonville, Florida
 Contributors xvii

Vu Nguyen, MD Todd Otteson, MD, MPH

Assistant Professor Chief
Department of Pediatric Critical Care Division of Pediatric Otolaryngology
Virginia Commonwealth University University Hospitals/Rainbow Babies and Children’s Hospital
Richmond, Virginia Cleveland, Ohio

Jenna R. Nickless, PharmD Yves Ouellette, MD, PhD

Critical Care Pharmacist Assistant Professor
Inpatient Pharmacy Division of Critical Care Medicine
Seattle Children’s Hospital Department of Pediatrics
Seattle, Washington Mayo Clinic
Rochester, Minnesota
Akira Nishisaki, MD
Associate Director, Clinical Implementation Program, ICU Daiva Parakininkas, MD
Department of Anesthesiology and Critical Care Medicine Associate Professor
The Children’s Hospital of Philadelphia Department of Pediatrics
Philadelphia, Pennsylvania Medical College of Wisconsin
Milwaukee, Wisconsin
Victoria F. Norwood, MD
Robert J. Roberts Professor of Pediatrics Robert I. Parker, MD
Chief of Pediatric Nephrology Professor Emeritus
Department of Pediatrics Department of Pediatrics
University of Virginia Stony Brook Children’s Hospital
Charlottesville, Virginia Stony Brook University Renaissance School of Medicine
Stony Brook, New York
Daniel A. Notterman, MA, MD
Professor Katherine Ratzen Peeler, MD
Department of Molecular Biology Department of Pediatrics
Princeton University Division of Medical Critical Care
Princeton, New Jersey Boston Children’s Hospital
Boston, Massachusetts
Peter Oishi, MD
Professor of Pediatrics Francisco A. Perez, MD, PhD
University of California, San Francisco; Assistant Professor of Pediatric Radiology
Executive Medical Director Department of Radiology
Inpatient Services and Regional Access Seattle Children’s Hospital and University of Washington
UCSF Beinoff Children’s Hospital Seattle, Washington
San Francisco, California
Melvin G. Perry Jr, MD
Jeffrey Ojemann, MD Pediatric Intensivist
Professor Department of Pediatrics
Department of Neurological Surgery Piedmont Henry Hospital
University of Washington Stockbridge, Georgia;
Seattle, Washington Pediatric Intensivist
Department of Pediatrics
Michelle L. Olson, MD WellStar Hospital
Department of Pediatric Critical Care Marietta; Georgia
Children’s Hospital of Richmond at VCU
Richmond, Virginia Mark J. Peters, MBChB, MRCP(UK), FRCPCH, PhD
Professor of Paediatric Intensive Care
Jessie O’Neal, PharmD, BCCCP Respiratory, Critical Care and Anaesthesia Unit
Critical Care Pharmacist UCL Great Ormond Street Institute of Child Health;
Seattle Children’s Hospital Honorary Consultant Paediatric Intensivist
Seattle, Washington Paediatric Intensivist Care Unit
Great Ormond Street Hospital for Children NHS Trust
Kirsten Orloff, MD London, United Kingdom
Pediatric Critical Care Medicine Fellow
Department of Pediatrics
Duke University Hospital
Durham, North Carolina
xviii Contributors

Brent J. Pfeiffer, MD, PhD Thomas M. Raffay, MD

Assistant Professor Assistant Professor
Department of Pediatrics Department of Pediatrics and Neonatology
Division of Critical Care Medicine Rainbow Babies and Children’s Hospital
University of Miami Cleveland, Ohio
Miami, Florida
Prakadeshwari Rajapreyar, MD, FAAP
Rachel Phelan, MD, MPH Pediatric Critical Care
Assistant Professor of Pediatrics Medical College of Wisconsin
Division of Hematology/Oncology/Blood and Marrow Milwaukee, Wisconsin
Transplant
Medical College of Wisconsin Lauren Rakes, MD
Milwaukee, Wisconsin Clinical Assistant Professor
Department of Pediatrics
Joseph Philip, MD, FAAP Division of Critical Care Medicine
Associate Professor University of Washington
Medical Director Seattle, Washington
Pediatric Cardiac ICU
Congenital Heart Center Rafael G. Ramos-Jimenez, MD
University of Florida Surgery Resident
Gainesville, Florida Department of General Surgery
UPMC Presbyterian Shadyside
Neethi Pinto, MD, MS Pittsburgh, Pennsylvania
Assistant Professor
Children’s Hospital of Philadelphia Samiran Ray, MBBChir, MA
Philadelphia, Pennsylvania Consultant
Department of Paediatric Intensive Care Medicine
Murray M. Pollack, MD, MBA Great Ormond Street Hospital NHS Foundation Trust
Professor of Pediatrics London, United Kingdom
Department of Pediatrics
George Washington University School of Medicine and Health Christopher R. Reed, MD
Sciences; Resident Physician
Director, Clinical Outcomes Research Department of Surgery
Department of Critical Care Duke University Medical Center
Children’s National Medical Center Durham, North Carolina
Washington, DC
James J. Reese Jr, MD
Thomas J. Preston, BS, CCP, FPP Associate Professor of Neurology
Innovative ECMO Concepts, Inc. Department of Neurology
Arcadia, Oklahoma University of New Mexico
Albuquerque, New Mexico
Parthak Prodhan, MD
Professor Kyle J. Rehder, MD
Pediatric Critical Care Associate Professor
University of Arkansas/Arkansas Children’s Hospital Department of Pediatrics
Little Rock, Arkansas Duke Children’s Hospital;
Physician Quality Officer
Lawrence Quang, MD Duke Center for Healthcare Safety and Quality
Professor Duke University Health System
Department of Pediatrics Durham, North Carolina
College of Medicine
University of Arkansas for Medical Sciences Kenneth E. Remy, MD, MSCI, FCCM
Little Rock, Arkansas Assistant Professor of Pediatrics and Internal Medicine
Adult and Pediatric Critical Care Medicine
Michael W. Quasney, MD Washington University in St. Louis
Associate Professor St. Louis, Missouri
Department of Pediatrics
Division of Critical Care Jorge D. Reyes, MD
University of Michigan Medical School Professor and Chief, Transplant Surgery
Ann Arbor, Michigan University of Washington School of Medicine
Seattle, Washington
Another random document with
no related content on Scribd:
 es souvenirs, ce soir, me séparent de toi;
Au-dessus de tes yeux, de ta voix qui me parle,
De ce frais horizon d’églises et de toits,
J’entends, dans ma mémoire où frémit leur émoi,
Les hirondelles sur le ciel d’Arles!

La nuit était torride à l’heure du couchant.

Les doux cieux languissaient comme une barcarolle;
Deux colonnes des Grecs, levant leurs bras touchants,
Semblaient une Andromaque éplorée, et cherchant
A fléchir une ombre qui s’envole!

Ce qu’un beau soir contient de perfide langueur

Ployait dans un silence empli de bruits infimes;
Je regardais, les mains retombant sur mon cœur,
Briller ainsi qu’un vase où coule la chaleur,
Le pâle cloître de Saint-Trophime!

Une brise amollie et peinte de parfums,

Glissait, silencieuse, au bord gisant du Rhône.
Tout ce que l’on obtient me semblait importun,
Mes pensers, mes désirs, s’éloignaient un à un
Pour monter vers d’invisibles zones!

O soleil, engourdi par les senteurs du thym,

Parfums de poivre et d’huile épandus sur la plaine,
Rochers blancs, éventés, où, dans l’air argentin,
On croit voir, se gorgeant des flots du ciel latin,
Les rapides Victoires d’Athènes!

Soir torturé d’amour et de pesants tourments,

Grands songes accablés des roseaux d’Aigues-Mortes,
Musicale torpeur où volent des flamants
Musicale torpeur où volent des flamants,
Couleur du soir divin qui promets et qui ments,
C’est ta détresse qui me transporte!

Ah! les amants unis, qui dorment, oubliés,

Dans les doux Alyscamps bercés du clair de lune,
Connaissent, sous le vent léger des peupliers,
Le bonheur de languir, assouvis et liés,
Dans la même amoureuse infortune;

Mais les corps des vivants, aspirés par l’été,

Sont des sanglots secrets que tout l’azur élance.
Je songeais sans parler, lointaine à vos côtés;
Qui jamais avouera l’âpre infidélité
D’un cœur sensuel, dans le silence!...
LA NUIT FLOTTE...
 a nuit flotte, amollie, austère, taciturne,
Impérieuse; elle est funèbre comme une urne
Qui se clôt sur un vague et sensible trésor.
Un oiseau, intrigué, dans un arbre qui dort,
Parait interroger l’ombre vertigineuse.
La lune au sec éclat semble une île pierreuse;
Cythère aride et froide où tout désir est mort.

Une vague rumeur émane du silence.

Un train passe au lointain, et son essoufflement
Semble la palpitante et paisible cadence
Du coteau qui respire et songe doucement...

Un parfum délicat, abondant, faible et dense,

Mouvant et spontané comme des bras ouverts,
Révèle la secrète et nocturne existence
Du monde végétal au souffle humide et vert.

Et je suis là. Je n’ai ni souhait, ni rancune;

Mon cœur s’en est allé de moi, puisque ce soir
Je n’ai plus le pouvoir de mes grands désespoirs,
Et que, paisiblement, je regarde la lune.

Je suis la maison vide où tout est flottement.

Mon cœur est comme un mort qu’on a mis dans la tombe;
J’ai longuement suivi ce bel enterrement,
Avec des cris, des deuils, du sang, des tremblements,
Et des égorgements d’agneaux et de colombes.

Mais le temps a séché l’eau des pleurs et le sel.

D’un œil indifférent, sans regret, sans appel,
Eclairé par la calme et triste intelligence,
Je regarde la voûte immense où les mortels
Je regarde la voûte immense, où les mortels
Ont suspendu les vœux de leur vaine espérance,

Et je ne vois qu’abîme, épouvante, silence;

Car, ô nuit! vous gardez le deuil continuel
De ce que rien d’humain ne peut être éternel...
L’ÉVASION
 ibre! comprends-tu bien! être libre, être libre!
Ne plus porter le poids déchirant du bonheur,
Ne plus sentir l’amère et suave langueur
Envahir chaque veine, amollir chaque fibre!

Libre, comme une biche avant le chaud printemps!

Bondir sans rechercher l’ardeur de la poursuite,
Et, dans une ineffable et pétulante fuite,
Disperser la nuée et les vents éclatants!

Se vêtir de fraîcheur, de feuillage, de prismes,

S’éclabousser d’azur comme d’un flot léger;
Goûter, sous les parfums compacts de l’oranger,
Un jeune, solitaire et joyeux héroïsme!

A peine l’aube naît, chaque maison sommeille;

L’atmosphère, flexible et prudente corbeille,
Porte le monde ainsi que des fruits nébuleux.
On croit voir s’envoler le coteau mol et bleu.
Tout à coup, le soleil, ramassé dans l’espace,
Eclate, et vient viser toute chose qui passe;
La brise, étincelante et forte comme l’eau,
Jette l’odeur des fleurs sur le cœur des oiseaux,
Mêle les flots marins, dont la cime moelleuse
Fond dans une douceur murmurante, écumeuse...
Que mon front est joyeux, que mes pas sont dansants!
Je m’élance, je marche au bord des cieux glissants:
Dans mes songes, mes mains se sont habituées
A dénouer le voile odorant des nuées!
L’étendue argentée est un tapis mouvant
Où court la verte odeur des figuiers et du vent;
Dans les jardins bombés, qu’habite un feu bleuâtre,
Les épais bananiers, au feuillage en haillons,
Elancent de leurs flancs, crépitants de rayons,
Le fougueux bataillon des fruits opiniâtres.
Je regarde fumer l’Etna rose et neigeux;
Les enfants, sur les quais, ont commencé leurs jeux.
Chaque boutique, avec ses câpres, ses pastèques,
Baisse sa toile; on voit briller l’enseigne grecque
Sur la porte, qu’un jet de tranchante clarté
Fait scintiller ainsi qu’un thon que le flot noie;
Tout est délassement, espoir, activité;
Mais quel désir d’amour et de fécondité,
Hélas! s’éveille au fond de toute grande joie!

Et pour un nouveau joug, ô mortels! Eros ploie

La branche fructueuse et forte de l’été...
CEUX QUI N’ONT RESPIRÉ...
 eux qui n’ont respiré que les nuits de Hollande,
Les tulipes des champs, les graines des bouleaux,
Le vent rapide et court qui chante sur la lande,
Les quais du Nord jetant leur goudron sur les flots,

Ceux qui n’ont contemplé que les blés et les vignes

Croissant tardivement sous des cieux incertains,
Qui n’ont vu que la blanche indolence des cygnes
Que Bruges fait flotter dans ses brumeux matins,

Ceux pour qui le soleil, au travers du mélèze,

Pendant les plus longs jours d’avril ou de juillet,
Remplace la splendeur des campagnes malaises,
Et les soirs sévillans enivrés par l’œillet,

Ceux-là, vivant enclos dans leurs frais béguinages,

Souhaitent le futur et vague paradis,
Qui leur promet un large et flamboyant voyage
Où s’embarquent les cœurs confiants et hardis.

Mais ceux qui, plus heureux, ont connu votre audace,

O bleuâtre Orient! Incendie azuré,
Prince arrogant et fier, favori de l’espace,
Monstre énorme, alangui, dévorant et doré;

Ceux qui, sur le devant de leur ronde demeure,

Coupole incandescente, opacité de chaux,
Ont vu la haute palme éparpiller les heures,
Qui passent sans marquer leurs pieds sur les cieux chauds;

Ceux qui rêvent le soir dans le grand clair de lune,

Aurore qui soudain met sa robe d’argent
 u o e qu souda et sa obe d a ge t
Et trempe de clarté la rue étroite et brune,
Et le divin détail des choses et des gens,

Ceux qui, pendant les nuits d’ardente poésie,

Egrenant un collier fait de bois de cyprès,
Contemplent, aux doux sons des guitares d’Asie,
Le long scintillement d’un jet d’eau mince et frais,

Ceux-là n’ont pas besoin des infinis célestes;

Nul immortel jardin ne surpasse le leur;
Ils épuisent le temps, pendant ces longues siestes
Où leur corps étendu porte l’ombre des fleurs.

Leur âme nonchalante, et d’azur suffoquée,

Cherche la Mort, pareille à l’ombrage attiédi
Que font le vert platane et la jaune mosquée
Sur le col des pigeons, attristés par midi...
LE CIEL BLEU DU MILIEU DU JOUR...
e ciel bleu du milieu du jour vibre, travaille,
Encourage les champs, les vignes, les semailles,
Comme un maître exalté au milieu des colons!
Tout bouge; sous les frais marronniers du vallon,
L’abeille noire, avec ses bonds soyeux et brusques,
Semble un éclat volant de quelque amphore étrusque.
Sur les murs villageois, le vert abricotier
S’écartèle, danseur de feuillage habillé.
Les parfums des jardins font au-dessus du sable,
Une zone qui semble au cœur infranchissable.
L’air fraîchit. On dirait que de secrets jets d’eau
Sous les noirs châtaigniers suspendent leurs arceaux.
L’hirondelle, toujours par une autre suivie,
Tourne, et semble obéir à des milliers d’aimants:
L’espace est sillonné par ces rapprochements...
Et parfois, à côté de cette immense vie
On voit, protégé par un mur maussade et bas,
Le cimetière où sont, sans regard et sans pas,
Ceux pour qui ne luit plus l’étincelante fête,
Qui fait d’un jour d’été une heureuse tempête!
Hélas! dans le profond et noir pays du sol,
Malgré les cris du geai, le chant du rossignol,
Ils dorment. Une enfant, sans frayeur, près des tombes,
Traîne un jouet brisé qui ricoche et retombe.
Ils sont là, épandus dans les lis nés sur eux,
Ces doux indifférents, ces grands silencieux;
Et la route qui longe et contourne leur pierre,
Eclate, rebondit d’un torrent de poussière
Que soulève, en passant, le véhément parcours
Des êtres que la mort prête encor à l’amour...
Et moi qui vous avais délaissée, humble terre,
Pour contempler la nue où l’âme est solitaire,
Je sais bien qu’en dépit d’un rêve habituel,
Nul ne saurait quitter vos chemins maternels.
En vain, l’intelligence, agile et sans limite,
Avide d’infini, vous repousse et vous quitte;
E i d l i l i d b i
En vain, dans les cieux clairs, de beaux oiseaux pensants
Peuplent l’azur soumis d’héroïques passants,
Ils seront ramenés et liés à vos rives,
Par le poids du désir, par les moissons actives,
Par l’odeur des étés, par la chaleur des mains...

Vaste Amour, conducteur des éternels demains,

Je reconnais en vous l’inlassable merveille,
L’inexpugnable vie, innombrable et pareille:
O croissance des blés! ô baisers des humains!
LA TERRE
 Je me suis mariée à vous
Terre fidèle, active et tendre,
Et chaque soir je viens surprendre
Votre arome secret et doux.

Ah! puisque le divin Saturne

Porte un anneau qui luit encore,
Je vous donne ma bague d’or,
Petite terre taciturne!

Elle est comme un soleil étroit,

Elle est couleur de moisson jaune,
Aussi chaude qu’un jeune faune
Puisqu’elle a tenu sur mon doigt!

—Et qu’un jour, dans l’espace immense,

Brille, ceinte d’un lien doré,
La Terre où j’aurai respiré
Avec tant d’âpre véhémence!
UN SOIR A LONDRES
 es parfums vont en promenade
Sur l’air brumeux,
Une âme ennuyée et malade
Flotte comme eux.

Les rhodendrons des pelouses,

D’un lourd éclat,
Semblent des collines d’arbouses
Et d’ananas.

Un temple grec dans le feuillage

Semble un secret,
Où Vénus voile son visage
Dans ses doigts frais.

O petit fronton d’Ionie,

Que tu me plais,
Dans la langoureuse agonie
D’un soir anglais!

Je t’enlace, je veux suspendre

A ta beauté,
Mon cœur, ce rosier le plus tendre
De tout l’été.

Mais sur tant de langueur divine

Quel souffle prompt?
Je respire l’odeur saline,
Et le goudron!