PedsCrit

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Charles Berde, MD, PhD, is the Sara Page Mayo Chair in Pediatric Pain Medicine and a Professor of Anaesthesia at Harvard Medical School. As a co-founder of the Pain Treatment Center at Boston Children's Hospital, he has spent decades at the forefront of pediatric analgesic pharmacology and the development of novel local anesthetics. His extensive translational research focuses on local anesthetic mechanisms and prolonged-duration formulations, making him a preeminent authority on the physiological impacts and safety profiles of these agents in neonates and children. A recipient of the Myron Yaster Lifetime Achievement Award from the Society for Pediatric Anesthesia, Dr. Berde brings unparalleled expertise to the discussion of managing and preventing local anesthetic systemic toxicity (LAST) within the high-stakes environments of the PICU and pediatric operating rooms.

Guest Conflicts of Interest (COI)

Algavita Bio: Collaborator/Developer of novel, prolonged-duration local anesthetics.
Quiver Bioscience: Unpaid Scientific Advisor and co-PI on an NINDS-HEAL grant focused on rare disease pain treatments.
Latigo Biotherapeutics: Scientific Advisor and recipient of past research support for novel analgesics development.
Algos: Scientific Advisor for non-opioid analgesics development.

Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to the management of local anesthetic systemic toxicity (LAST) in children.

References:

Patient and Doctor Reconcile for Greater Good

Berde CB. Toxicity of local anesthetics in infants and children. J Pediatr. 1993 May;122(5 Pt 2):S14-20. doi: 10.1016/s0022-3476(11)80004-1.

McMahon K, Paster J, Baker KA. Local anesthetic systemic toxicity in the pediatric patient. Am J Emerg Med. 2022 Apr;54:325.e3-325.e6. doi: 10.1016/j.ajem.2021.10.021. Epub 2021 Oct 25.

Lavonas et al. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Oct 17;148(16):e149-e184. doi: 10.1161/CIR.0000000000001161. Epub 2023 Sep 18.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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About our Guests:

Fran Balamuth, MD, PhD, MSCE, is division chief of Pediatric Emergency Medicine at the Children’s Hospital of Philadelphia. Dr. Balamuth’s research interests focus on pediatric sepsis recognition using epidemiologic and translational approaches, for which she has received NIH and foundation funding. She is the co-PI of the PROMPT BOLUS trial, a multinational pragmatic trial comparing saline vs balanced fluids in pediatric sepsis, which will be the largest acute care pediatric trial in history. In addition, she co-leads the CHOP Pediatric Sepsis Program, which supports and promotes local clinical, research, educational, and quality-improvement initiatives related to sepsis. She is an internationally recognized sepsis leader, and has been invited to serve on the national steering committee for the Improving Pediatric Sepsis Outcomes quality collaborative through the US Children’s Hospital Association, and 2 international task forces focused on defining pediatric sepsis through the US Centers for Disease Control and Prevention and the Society of Critical Care Medicine.

Scott L. Weiss, MD, MSCE, FCCM, is a Professor of Pediatrics & Pathology and Genomic Medicine at Thomas Jefferson University and division chief of Critical Care Medicine at Nemours Children’s Hospital, Delaware. Previously, Dr. Weiss was on the faculty at the Children’s Hospital of Philadelphia, where he earned recognition as an international expert in pediatric sepsis. Dr. Weiss’ NIH-funded research focuses on epidemiology, fluid resuscitation, and mitochondrial dysfunction in pediatric sepsis. Dr. Weiss is an international expert in pediatric sepsis and served as the co-PI of the PRoMPT BOLUS trial.

Nathan Kuppermann, MD, MPH, is Executive Vice President and Chief Academic Officer of Children's National Hospital and Director of the Children's National Research Institute. He also serves as chair of the Department of Pediatrics and associate dean of Pediatric Academic Affairs at the George Washington University School of Medicine and Health Sciences. He is an internationally recognized clinical trialist in pediatric trauma, pediatric DKA, and acute pediatric infections. As the original chair of the Pediatric Emergency Medicine Applied Research Network (PECARN); his research is focused on clinical trials and clinical prediction rules using large cohorts of acutely ill and injured children. Dr. Kuppermann served as the senior investigator of the PRoMPT BOLUS trial.

Selected References:

Weiss SL, Balamuth F, Long E, Thompson GC, Hayes KL, Katcoff H, Cook M, Tsemberis E, Hickey CP, Williams A, Williamson-Urquhart S, Borland ML, Dalziel SR, Gelbart B, Freedman SB, Babl FE, Huang J, Kuppermann N; Pragmatic Pediatric Trial of Balanced Versus Normal Saline Fluid in Sepsis (PRoMPT BOLUS) Investigators of the PECARN, PERC, and PREDICT Networks. PRagMatic Pediatric Trial of Balanced vs nOrmaL Saline FlUid in Sepsis: study protocol for the PRoMPT BOLUS randomized interventional trial. Trials. 2021 Nov 6;22(1):776. doi: 10.1186/s13063-021-05717-4. Erratum in: Trials. 2025 Oct 7;26(1):390. doi: 10.1186/s13063-025-09164-3. PMID: 34742327; PMCID: PMC8572061.
Weiss SL, Balamuth F, Thurm CW, Downes KJ, Fitzgerald JC, Laskin BL. Major Adverse Kidney Events in Pediatric Sepsis. Clin J Am Soc Nephrol. 2019 May 7;14(5):664-672. doi: 10.2215/CJN.12201018. Epub 2019 Apr 18. PMID: 31000518; PMCID: PMC6500940.
Semler MW, Self WH, Wanderer JP, Ehrenfeld JM, Wang L, Byrne DW, Stollings JL, Kumar AB, Hughes CG, Hernandez A, Guillamondegui OD, May AK, Weavind L, Casey JD, Siew ED, Shaw AD, Bernard GR, Rice TW; SMART Investigators and the Pragmatic Critical Care Research Group. Balanced Crystalloids versus Saline in Critically Ill Adults. N Engl J Med. 2018 Mar 1;378(9):829-839. doi: 10.1056/NEJMoa1711584. Epub 2018 Feb 27. PMID: 29485925; PMCID: PMC5846085.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Learn more about the ACTION learning network at this link.

About our Guest:

Tanya Perry, DO, is the director of the VAD Program at Cohen Children’s Medical Center. She earned her medical degree from Nova Southeastern University and completed her pediatric critical care fellowship training at Cohen Children’s Medical Center, followed by pediatric cardiology fellowship at Cincinnati Children’s Hospital, where she subsequently practiced for 3 years as a cardiac intensivist. Dr. Perry’s clinical and research efforts are focused on improving outcomes in children supported with mechanical circulatory support.

Selected References:

Ventricular Assist Device Therapy - ClinicalKey

Berlin Heart EXCOR and ACTION post-approval surveillance study report - PubMed

ABCs of Stroke Prevention | Circulation: Cardiovascular Quality and Outcomes

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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About our Guest:

Tanya Perry, DO, is the director of the VAD Program at Cohen Children’s Medical Center. She earned her medical degree from Nova Southeastern University and completed her pediatric critical care fellowship training at Cohen Children’s Medical Center, followed by pediatric cardiology fellowship at Cincinnati Children’s Hospital, where she subsequently practiced for 3 years as a cardiac intensivist. Dr. Perry’s clinical and research efforts are focused on improving outcomes in children supported with mechanical circulatory support.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Describe the common clinical scenarios that warrant VAD
List the clinical factors impacting device selection
Explain the independent and dependent variables associated with each device, as well as the cannulation strategy other important monitoring pearls

Selected References:

Ventricular Assist Device Therapy - ClinicalKey

Berlin Heart EXCOR and ACTION post-approval surveillance study report - PubMed

ABCs of Stroke Prevention | Circulation: Cardiovascular Quality and Outcomes

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Robert Pass is Professor of Pediatrics and Chief of the Division of Pediatric Cardiology at the Icahn School of Medicine at Mount Sinai and Mount Sinai Kravis Children’s Hospital. He is Co-Director of the Mount Sinai Kravis Children’s Heart Center and Director of Pediatric Electrophysiology at the Mount Sinai Health System. In addition to his exceptional clinical work as an electrophysiologist, he is the host of the very successful medical education podcast Pediheart: Pediatric Cardiology Today.

Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to the evaluation and management of high-grade atrioventricular block in children.

References:

PediHeart Podcast with Robert Pass

https://www.youtube.com/@RobertPassPediheart

Kusumoto et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol. 2019 Aug 20;74(7):932-987.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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About our Guests:

Catherine Ross, MD, is a pediatric critical care physician in the Division of Medical Critical Care at Boston Children’s Hospital (BCH) and Assistant Professor at Harvard Medical School. She serves on the joint American Heart Association (AHA) and American Academy of Pediatrics national writing group for Pediatric Advanced Life Support 2025 guidelines as well as the AHA Emergency Cardiovascular Care Science Subcommittee and Pediatric Emphasis Group. Her research interests lie in pediatric resuscitation, specifically in designing and implementing high-quality randomized controlled trials in the pre- and intra-arrest periods. Specific areas of interest include peri-arrest bolus epinephrine, intra-arrest drug management, and massive pulmonary embolism in children.

Ryan Morgan is a pediatric intensivist and Associate Professor at the Children’s Hospital of Philadelphia, where he is the Associate Director of the CHOP Resuscitation Science Center and the Associate Division Chief for Faculty Affairs. He was a writing group member for the 2025 AHA/AAP PALS Guidelines and currently serves on the International Liaison Committee on Resuscitation’s Pediatric Life Support Task Force. Ryan's research focuses on intra-arrest physiology and on using physiology to guide resuscitation therapies. He is currently leading PEDICA, an NHLBI-funded study underway across 22 hospitals in the pediRES-Q network examining the physiologic effects of epinephrine during pediatric cardiac arrest.

Selected References:

Cardiac Arrest Pharmacopeia, Critical Care Clinics, 2025
Peri-arrest bolus epinephrine practices amongst pediatric resuscitation experts - PMC Resusc Plus. 2022
Physiologic response to pre-arrest bolus dilute epinephrine in the pediatric intensive care unit - PMC Resuscitation. 2018
The physiologic response to epinephrine and pediatric cardiopulmonary resuscitation outcomes - PubMed Crit Care. 2023
Comparison of vasopressin to epinephrine during pediatric in-hospital cardiac arrest: survival and physiologic responsiveness - PubMed Pediatric Research. 2025
Epinephrine Dosing Intervals Are Associated With Pediatric In-Hospital Cardiac Arrest Outcomes: A Multicenter Study - PubMed. Crit Care Med. 2024

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Dr. Merritt Tuttle is both a Pediatric Intensivist and Medical Toxicologist at Brenner Children's Hospital in North Carolina associated with Atrium Health and Wake Forest Baptist Health. She completed her Pediatric Critical Care and Medical Toxicology training at the Medical College of Wisconsin.

Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence based and expert guided approach to the evaluation and management of the critically ill child with calcium channel blocker toxicity.

References:

St-Onge M, Anseeuw K, Cantrell FL et al, Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults. Crit Care Med. 2017 Mar;45(3):e306-e315.

2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Levine M, Curry SC, Padilla-Jones A, Ruha AM. Critical care management of verapamil and diltiazem overdose with a focus on vasopressors: a 25-year experience at a single center. Ann Emerg Med. 2013 Sep;62(3):252-8. doi: 10.1016/j.annemergmed.2013.03.018.

Cole JB, Arens AM, Laes JR, Klein LR, Bangh SA, Olives TD. High dose insulin for beta-blocker and calcium channel-blocker poisoning. Am J Emerg Med. 2018 Oct;36(10):1817-1824. doi: 10.1016/j.ajem.2018.02.004. Epub 2018 Feb 6.

Slamowitz A, Sweberg T, Labgold K, Nickerson T. Extracorporeal Membrane Oxygenation for Calcium Channel Blocker Intoxication: A Multicenter Retrospective Registry Review. ASAIO J. 2025 Oct 31.

Poison Control: (800) 222-1222

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Ayesha Zia, MD, is a Professor of Pediatrics at UT Southwestern Medical Center and a nationally recognized expert in pediatric thrombosis, with particular emphasis on the diagnosis, management, and long-term outcomes of pulmonary embolism in children and adolescents. She serves as Director of the Pediatric Hemostasis and Thrombosis Program at Children’s Health Dallas. She has led the development of a collaborative multidisciplinary approach to pediatric PE care, including pulmonary embolism response teams. Her October 2025 publication in Blood “How I treat pediatric pulmonary embolism” is the topic of today’s discussion

Learning Objective: By the end of this podcast, listeners should be able to describe an evidence-based and expert-guided approach to the diagnosis, risk stratification and management of pulmonary embolism in children.

References:

Zia A, Goldenberg NA, Rajpurkar M. How I treat pediatric pulmonary embolism. Blood. 2025 Oct 2;146(14):1643-1653. doi: 10.1182/blood.2024026599.

Dang MP, Cheng A, Garcia J, Lee Y, Parikh M, McMichael ABV, Han BL, Pimpalwar S, Rinzler ES, Hoffman OL, Baltagi SA, Bowens C, Divekar AA, Davis Volk AP, Huang CJ, Veeram Reddy SR, Arar Y, Zia A. Bringing PERT to Pediatrics: Initial Experience and Outcomes of a Pediatric Multidisciplinary Pulmonary Embolism Response Team (PERT). Chest. 2025 Mar;167(3):851-862.

Mercurio L, Corwin D, Kaplan R, Ellison AM, Casper TC, Kuppermann N, Kline JA. Bedside exclusion of pulmonary embolism in children without radiation (BEEPER): a national study of the Pediatric Emergency Care Applied Research Network-Study protocol. Res Pract Thromb Haemost. 2023 Jan 14;7(2):100046.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Jaime Jump, DO, is a dual-trained physician specializing in pediatric critical care and palliative care. She currently serves as the Program Director of Palliative Care and is an Associate Professor in the Sections of Critical Care Medicine and Pediatric Palliative Care atBaylor College of Medicine and Texas Children’s Hospital.

Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to Withdrawal of Life Sustaining Therapy (WOLST) in children.

References:

TEXAS CHILDREN’S HOSPITAL DIVISION OF PALLIATIVE CARE Withdrawal of Life-Sustaining Therapies (WOLST) Protocol

Kompanje EJ, van der Hoven B, Bakker J. Anticipation of distress after discontinuation of mechanical ventilation in the ICU at the end of life. Intensive Care Med. 2008 Sep;34(9):1593-9. doi: 10.1007/s00134-008-1172-y. Epub 2008 May 31.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Learning Objectives:

By the end of this two-part series, listeners should be able to discuss an evidence-based and expert-guided approach to RBC transfusion in critically ill children.

About our Guests:

Kailey Remien is a Pediatric Critical Care fellow at Nationwide Children’s Hospital whose research uses data science and geospatial methods to study bronchiolitis and health equity. She leads the social determinants of health ancillary group within the international BACON 2.0 study and is passionate about improving outcomes for critically ill children.

Jennifer Muszynski is a pediatric intensivist at Nationwide Children’s Hospital. A leading expert in transfusion medicine, she studies how blood products interact with the immune system and influence outcomes in critically ill children. Her ongoing clinical and translational studies are aimed at using machine learning to dissect complex interactions between host immune cell function, inflammation, blood product transfusion, and clinical outcomes in children with sepsis, trauma, acute lung injury, and multiple organ dysfunction.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Learning Objectives:

By the end of this two-part series, listeners should be able to discuss an evidence-based and expert-guided approach to RBC transfusion in critically ill children.

About our Guests:

Kailey Remien is a Pediatric Critical Care fellow at Nationwide Children’s Hospital whose research uses data science and geospatial methods to study bronchiolitis and health equity. She leads the social determinants of health ancillary group within the international BACON 2.0 study and is passionate about improving outcomes for critically ill children.

Jennifer Muszynski is a pediatric intensivist at Nationwide Children’s Hospital. A leading expert in transfusion medicine, she studies how blood products interact with the immune system and influence outcomes in critically ill children. Her ongoing clinical and translational studies are aimed at using machine learning to dissect complex interactions between host immune cell function, inflammation, blood product transfusion, and clinical outcomes in children with sepsis, trauma, acute lung injury, and multiple organ dysfunction.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Tobias Straube, MD, is an Assistant Professor of Pediatrics in the Division of Critical Care Medicine at Duke University School of Medicine, where he has served since joining the faculty in July 2021. He completed his pediatric residency and critical care fellowship at Duke University Hospital following earning his medical degree from McGovern Medical School at UTHealth.

COI disclosure: Dr. Straube is the Chief Medical Officer of VQ Biomedical working to develop a minimally-invasive oxygenator catheter. This work is unrelated to this content discussed in today's episode.

Learning Objective:

By the end of this podcast, listeners should be able to describe an evidence-based and expert-guided clinical approach to the recognition and management of exertional heat stroke in critically-ill children.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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About our Guests:

Dr. Alexis Bragg is a Clinical Associate Professor of Anesthesiology and Pediatrics at Keck School of Medicine of USC in Los Angeles.

Dr. Chinyere Egbuta is a Senior Associate in Anesthesiology and Critical Care Medicine at Boston Children’s Hospital and Assistant Professor of Anesthesia at Harvard Medical School.

Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine in Baltimore.

Learning Objective:

By the end of this podcast series, listeners should be able to discuss:

An expert approach to the peri-intubation management of the critically-ill child, including pre-oxygenation, apneic oxygenation +/- PPV, & the use of neuromuscular blockade
Strategies using direct vs. video laryngoscopy in academic PICUs
Recognize the need and discuss potential strategies for ongoing maintenance of airway management skills

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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About our Guests:

Dr. Alexis Bragg is a Clinical Associate Professor of Anesthesiology and Pediatrics at Keck School of Medicine of USC in Los Angeles.

Dr. Chinyere Egbuta is a Senior Associate in Anesthesiology and Critical Care Medicine at Boston Children’s Hospital and Assistant Professor of Anesthesia at Harvard Medical School.

Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine in Baltimore.

Learning Objective:

By the end of this podcast series, listeners should be able to discuss:

An expert approach to the peri-intubation management of the critically-ill child including pre-oxygenation, apneic oxygenation +/- PPV, & the use of neuromuscular blockade
Strategies using direct vs. video laryngoscopy in academic PICUs
Recognize the need and discuss potential strategies for ongoing maintenance of airway management skills

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Dr. Nicole Glaser is the Chief of Pediatric Endocrinology and a professor of Pediatrics at UC Davis Children's Hospital. She is recognized as an international expert in pediatric diabetic ketoacidosis (DKA), an important complication of diabetes in children. She has led many of the key multi-center studies that guide DKA management. She has also been involved in the development of several national and international guidelines for DKA management in children that guide current practice worldwide.
Learning Objective:

By the end of this podcast, listeners should be able to discuss an expert guided approach to the identification and management of children with hyperosmolar DKA.

Key reference:

Glaser N, Fritsch M, Priyambada L, Rewers A, Cherubini V, Estrada S, Wolfsdorf JI, Codner E. ISPAD clinical practice consensus guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2022 Nov;23(7):835-856.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children’s Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Recognize the impact of nutritional status on outcomes of critically-ill children.
Describe the key aspects of the metabolic stress response in critical illness.
Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.
Reflect on an expert’s approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence.

Selected references:

Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844.

Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children’s Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Recognize the impact of nutritional status on outcomes of critically-ill children.
Describe the key aspects of the metabolic stress response in critical illness.
Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.
Reflect on an expert’s approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence.

Selected references:

Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844.

Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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Learning Objectives:

By the end of this podcast, listeners should be able to:

Describe the pathophysiology associated with anticholinergic toxidrome
List the initial workup and management that every TCA ingestion patient should receive
Discuss best practices for initial resuscitation in TCA ingestions

About our Guest:

Dr. Joshua Nogar is an emergency medicine physician and toxicologist at Northwell Health and an associate professor of emergency medicine at Hofstra University. He is also the chief of the division of Medical Toxicology and the program director of the Toxicology Fellowship at North Shore University Hospital & Long Island Jewish Medical Center.

References:

https://toxandhound.com/category/dantastictox/page/2/
2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
https://emcrit.org/ibcc/nacb/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Nicole Glaser is the Chief of Pediatric Endocrinology and a professor of Pediatrics at UC Davis Children's Hospital. She is recognized as an international expert in pediatric diabetic ketoacidosis (DKA), an important complication of diabetes in children. She has led many of the key multi-center studies that guide DKA management. She has also been involved in the development of several national and international guidelines for DKA management in children that guide current practice worldwide.
Learning Objectives:

By the end of this podcast, listeners should be able to:

Describe best practices for triaging patients with DKA
Explain the pathophysiology of acute cerebral edema in DKA
Describe the evidence and physiologic basis for fluid selection and rate in DKA
Describe the evidence supporting insulin infusion rates in pediatric DKA
List best practices for lab monitoring in DKA, and how to define when a patient is ready for transition to subcutaneous insulin

References:

Abramo TJ, Szlam S, Hargrave H, Harris ZL, Williams A, Meredith M, Hedrick M, Hu Z, Nick T, Gonzalez CV. Bihemispheric Cerebral Oximetry Monitoring's Functionality in Suspected Cerebral Edema Diabetic Ketoacidosis With Therapeutic 3% Hyperosmolar Therapy in a Pediatric Emergency Department. Pediatr Emerg Care. 2022 Feb 1;38(2):e511-e518. doi: 10.1097/PEC.0000000000001774. PMID: 30964851.
Kuppermann N, Ghetti S, Schunk J, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018;378:2275-2287.
Glaser N, Barnett P, McCaslin I, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. N Engl J Med. 2001;344:264-269.
Bergmann KR, Abuzzahab MJ, Perepelista V, Udeogu J, Qiu L, Lammers S, Nickel A, Watson D, Kharbanda A. Improving Emergency Department Care for Children With Medium- and High-Risk Diabetic Ketoacidosis. Pediatrics. 2025 Oct 1;156(4):e2024068959. doi: 10.1542/peds.2024-068959. PMID: 40907982.
UC-Davis-Health-Magazine-Fall-2019.pdf

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Steven Shein, MD, FCCM, is the Chief of Pediatric Critical Care at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland, Ohio, and holds the Linsalata Family Distinguished Chair in Pediatric Critical Care and Emergency Medicine. He is also the Co-Director of the PICU Clinical, Basic & Translational Research Program and an Associate Director of the Pediatric Critical Care Medicine Fellowship program. His research focuses on critical bronchiolitis and long-term neuro-cognitive morbidity after critical illness.

Jatinder Dhami, MD, is a Pediatric Intensivist at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland, Ohio. She completed her pediatrics residency at Penn State in Hershey, PA, and her PICU fellowship at Riley Children's Hospital in Indianapolis, Indiana. She is interested in clinical ethics in pediatric critical illness.

Learning Objective:

By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to managing critical bronchiolitis.

References:

Managing Critical Bronchiolitis David G. Speicher, MD; and Steven L. Shein, MD, FCCM

Zurca et al. Management of Critical Bronchiolitis. Hosp Pediatr. 2023

Plint et al. Epinephrine and dexamethasone in children with bronchiolitis. N Engl J Med. 2009.

Schramm et al. Clinical Examination Does Not Predict Response to Albuterol in Ventilated Infants With Bronchiolitis. Pediatr Crit Care Med. 2017

Shein at al. Antibiotic Prescription in Young Children With Respiratory Syncytial Virus-Associated Respiratory Failure and Associated Outcomes. Pediatr Crit Care Med. 2019.

Gelbart et al. Pragmatic Randomized Trial of Corticosteroids and Inhaled Epinephrine for Bronchiolitis in Children in Intensive Care. J Pediatr. 2022.

Shein et al. Derivation and Validation of an Objective Effort of Breathing Score in Critically Ill Children. Pediatr Crit Care Med. 2019.

Shein SL, Rotta AT. Long-term Neurocognit

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Learning Objectives:

By the end of this two-part series, listeners should be able to discuss:

The physiologic rationale supporting the use of high-frequency percussive ventilation (Volumetric Diffusive Respiration, or HFPV).
Patient populations most likely to benefit from HFPV.
Key published evidence that informs our use of HFPV in pediatric critical care.
An expert approach to managing a patient with HFPV.
Next steps in research that will direct our understanding of the use of HFPV in pediatric critical care.

About our Guest:

Dr. John Lin is a Professor of Pediatrics at Washington University in St. Louis. He serves as the Critical Care Fellowship Program Director and Medical Director of Respiratory Care at St. Louis Children’s Hospital. His academic interests are aimed at the implementation of specific task-based processes and systems-based interventions that increase team performance.

References:

Butler AD, Dominick CL, Yehya N. High frequency percussive ventilation in pediatric acute respiratory failure. Pediatr Pulmonol. 2021 Feb;56(2):502-508. doi: 10.1002/ppul.25191. Epub 2020 Dec 8. PMID: 33258557; PMCID: PMC7902396.
Linda Melchor. (2021, July 22). High-Frequency Percussive Ventilation – Using the VDR, or HFPV-4. Criticalcarenow.Com.
Salim, A., & Martin, M. (2005). High-frequency percussive ventilation. Critical Care Medicine, 33(Supplement), S241–S245. https://doi.org/10.1097/01.CCM.0000155921.32083.CE
Dominick, C., Nickel, A. J., & Yehya, N. (2022). High Frequency Percussive Ventilation in Viral Bronchiolitis: Do We Need a Standardized Approach to HFPV Management? Https://Home.Liebertpub.Com/Rcare, 67(7), 893–894. https://doi.org/10.4187/RESPCARE.10247
White, B. R., Cadotte, N., McClellan, E. B., Presson, A. P., Bennett, E., Smith, A. G., & Aljabari, S. (2022). High-Frequency Percussive Ventilation in Viral Bronchiolitis. Respiratory Care, 67(7), 781–788. https://doi.org/10.4187/respcare.09350

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Learning Objectives:

By the end of this two-part series, listeners should be able to discuss:

The physiologic rationale supporting the use of high-frequency percussive ventilation (Volumetric Diffusive Respiration, or HFPV).
Patient populations most likely to benefit from HFPV.
Key published evidence that informs our use of HFPV in pediatric critical care.
An expert approach to managing a patient with HFPV.
Next steps in research that will direct our understanding of the use of HFPV in pediatric critical care.

About our Guest:

Dr. John Lin is a Professor of Pediatrics at Washington University in St. Louis. He serves as the Critical Care Fellowship Program Director and Medical Director of Respiratory Care at St. Louis Children’s Hospital. His academic interests are aimed at the implementation of specific task-based processes and systems-based interventions that increase team performance.

References:

Butler AD, Dominick CL, Yehya N. High frequency percussive ventilation in pediatric acute respiratory failure. Pediatr Pulmonol. 2021 Feb;56(2):502-508. doi: 10.1002/ppul.25191. Epub 2020 Dec 8. PMID: 33258557; PMCID: PMC7902396.
Linda Melchor. (2021, July 22). High-Frequency Percussive Ventilation – Using the VDR, or HFPV-4. Criticalcarenow.Com.
Salim, A., & Martin, M. (2005). High-frequency percussive ventilation. Critical Care Medicine, 33(Supplement), S241–S245. https://doi.org/10.1097/01.CCM.0000155921.32083.CE
Dominick, C., Nickel, A. J., & Yehya, N. (2022). High Frequency Percussive Ventilation in Viral Bronchiolitis: Do We Need a Standardized Approach to HFPV Management? Https://Home.Liebertpub.Com/Rcare, 67(7), 893–894. https://doi.org/10.4187/RESPCARE.10247
White, B. R., Cadotte, N., McClellan, E. B., Presson, A. P., Bennett, E., Smith, A. G., & Aljabari, S. (2022). High-Frequency Percussive Ventilation in Viral Bronchiolitis. Respiratory Care, 67(7), 781–788. https://doi.org/10.4187/respcare.09350

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Audrey Miller, MD, is an Attending Neonatologist at Nationwide Children's Hospital and an Assistant Professor of Pediatrics at The Ohio State University College of Medicine. Dr. Miller’s clinical interests focus on bronchopulmonary dysplasia (BPD) and improving outcomes for patients with this disease. Dr. Miller serves as Medical Director for the inpatient BPD unit at Nationwide Children’s. Dr. Miller also serves as chair for the advocacy committee of the international BPD collaborative.

Nationwide Children's Comprehensive Center for Bronchopulmonary Dysplasia (BPD)

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define BPD and describe the underlying pathophysiology, risk factors and clinical trajectory.
Develop a clinical approach to mechanical ventilation in infants with BPD.
Describe strategies for mitigating compilations and promoting well-being in infants with severe BPD.

Reference:

Miller AN, Kielt MJ, El-Ferzli GT, Nelin LD, Shepherd EG. Optimizing ventilator support in severe bronchopulmonary dysplasia in the absence of conclusive evidence. Front Pediatr. 2022 Nov 24;10:1022743.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Guillaume Emeriaud MD PhD is a Professor of Pediatrics at the University of Montreal and pediatric intensivist at Sainte Justine Hospital in Montreal, Canada. He is a physician scientist with a particular interest in improving pediatric assisted ventilation. In particular, he has developed expertise in monitoring diaphragmatic function by evaluating the electrical activity of the diaphragm. The results of this work have led to less invasive and more effective assistance for children, notably with the NAVA (neurally adjusted ventilatory assist) mode.

E-mail: guillaume.emeriaud.med@ssss.gouv.qc.ca

Learning Objective: By the end of this podcast, listeners should be able to discuss the physiologic rationale and an expert approach to managing a child with respiratory failure with NAVA.

References:

Bordessoule, A., Emeriaud, G., Morneau, S. et al. Neurally adjusted ventilatory assist improves patient–ventilator interaction in infants as compared with conventional ventilation. Pediatr Res 72, 194–202 (2012).
Sindelar R, McKinney RL, Wallström L, Keszler M. Proportional assist and neurally adjusted ventilation: Clinical knowledge and future trials in newborn infants. Pediatr Pulmonol. 2021 Jul;56(7):1841-1849.
Lepage-Farrell A, Tabone L, Plante V, Kawaguchi A, Feder J, Al Omar S, Emeriaud G. Noninvasive Neurally Adjusted Ventilatory Assist in Infants With Bronchiolitis: Respiratory Outcomes in a Single-Center, Retrospective Cohort, 2016-2018. Pediatr Crit Care Med. 2024 Mar 1;25(3):201-211.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Guillaume Emeriaud MD PhD is a Professor of Pediatrics at the University of Montreal and pediatric intensivist at Sainte Justine Hospital in Montreal, Canada. He is a physician scientist with a particular interest in improving pediatric assisted ventilation. In particular, he has developed expertise in monitoring diaphragmatic function by evaluating the electrical activity of the diaphragm. The results of this work have led to less invasive and more effective assistance for children, notably with the NAVA (neurally adjusted ventilatory assist) mode.

E-mail: guillaume.emeriaud.med@ssss.gouv.qc.ca

Learning Objective: By the end of this podcast, listeners should be able to discuss the physiologic rationale and an expert approach to managing a child with respiratory failure with NAVA.

References:

Bordessoule, A., Emeriaud, G., Morneau, S. et al. Neurally adjusted ventilatory assist improves patient–ventilator interaction in infants as compared with conventional ventilation. Pediatr Res 72, 194–202 (2012).
Sindelar R, McKinney RL, Wallström L, Keszler M. Proportional assist and neurally adjusted ventilation: Clinical knowledge and future trials in newborn infants. Pediatr Pulmonol. 2021 Jul;56(7):1841-1849.
Lepage-Farrell A, Tabone L, Plante V, Kawaguchi A, Feder J, Al Omar S, Emeriaud G. Noninvasive Neurally Adjusted Ventilatory Assist in Infants With Bronchiolitis: Respiratory Outcomes in a Single-Center, Retrospective Cohort, 2016-2018. Pediatr Crit Care Med. 2024 Mar 1;25(3):201-211.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Learning Objectives:

By the end of this series, listeners should be able to:

Understand the research expectations of PICU Fellows in the United States.
Explain the types of research available to PICU fellows and how a new fellow might explore their local options.
Explain the work necessary to refine a research question and write mature specific aims for a project.
Understand the key factors involved in getting a fellowship paper submitted, including the common pitfalls for each type of research

About our Guest:

Mike Spaeder is a Professor of Pediatrics at the University of Virginia (UVA) School of Medicine and a pediatric critical care physician at the UVA Children's Hospital in Charlottesville, Virginia. He received his bachelor’s degree in mathematics from Trinity College and his master’s in statistics from George Washington University, where he also received his medical degree. He completed his pediatrics residency at Hasbro Children's Hospital/Brown University and his pediatric critical care fellowship at the Johns Hopkins Hospital. He is now the director of the Pediatric Critical Care fellowship at the UVA Children's Hospital. His research is based at the Center for Advanced Medical Analytics at the University of Virginia, where he focuses on modeling physiologic signatures of illness to identify patients at risk for clinical deterioration.

Selected References:

Horvat CM, Hamilton MF, Hall MW, McGuire JK, Mink RB Child Health Needs and the Pediatric Critical Care Medicine Workforce: 2020-2040. Pediatrics 2024 Feb 1 153
Tasker RC. Writing for PCCM: The 3,000-Word Structured Clinical Research Report. Pediatr Crit Care Med. 2021 Mar 1;22(3):312-317.
Sanchez-Pinto, L. Nelson MD, MBI1; Badke, Colleen M. MD, MS1; Pololi, Linda MBBS, FRCP (hon)2. Group Peer Mentoring: A Strategy to Promote Career Development and Improve Well-Being Among Early-Career Faculty in Pediatric Critical Care Medicine. Pediatric Critical Care Medicine ():10.1097/PCC.0000000000003763, May 15, 2025. | DOI: 10.1097/PCC.0000000000003763
Scott K. Radical Candor: Be a Kick-Ass Boss Without Losing Your Humanity. New York: St. Martin's Press; 2017. 1st ed.
Equator Guidelines: https://www.equator-network.org/
For Authors : Pediatric Critical Care Medi

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Learning Objectives:

By the end of this series, listeners should be able to:

Understand the research expectations of PICU Fellows in the United States.
Explain the types of research available to PICU fellows and how a new fellow might explore their local options.
Explain the work necessary to refine a research question and write mature specific aims for a project.
Understand the key factors involved in getting a fellowship paper submitted, including the common pitfalls for each type of research

About our Guest:

Mike Spaeder is a Professor of Pediatrics at the University of Virginia (UVA) School of Medicine and a pediatric critical care physician at the UVA Children's Hospital in Charlottesville, Virginia. He received his bachelor’s degree in mathematics from Trinity College and his master’s in statistics from George Washington University, where he also received his medical degree. He completed his pediatrics residency at Hasbro Children's Hospital/Brown University and his pediatric critical care fellowship at the Johns Hopkins Hospital. He is now the director of the Pediatric Critical Care fellowship at the UVA Children's Hospital. His research is based at the Center for Advanced Medical Analytics at the University of Virginia, where he focuses on modeling physiologic signatures of illness to identify patients at risk for clinical deterioration.

Selected References:

Horvat CM, Hamilton MF, Hall MW, McGuire JK, Mink RB Child Health Needs and the Pediatric Critical Care Medicine Workforce: 2020-2040. Pediatrics 2024 Feb 1 153
Tasker RC. Writing for PCCM: The 3,000-Word Structured Clinical Research Report. Pediatr Crit Care Med. 2021 Mar 1;22(3):312-317.
Sanchez-Pinto, L. Nelson MD, MBI1; Badke, Colleen M. MD, MS1; Pololi, Linda MBBS, FRCP (hon)2. Group Peer Mentoring: A Strategy to Promote Career Development and Improve Well-Being Among Early-Career Faculty in Pediatric Critical Care Medicine. Pediatric Critical Care Medicine ():10.1097/PCC.0000000000003763, May 15, 2025. | DOI: 10.1097/PCC.0000000000003763
Scott K. Radical Candor: Be a Kick-Ass Boss Without Losing Your Humanity. New York: St. Martin's Press; 2017. 1st ed.
Equator Guidelines: https://www.equator-network.org/
For Authors : Pediatric Critical Care Medi

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Learning Objectives:

By the end of this series, listeners should be able to discuss:

The physiologic rationale supporting the use of airway pressure release ventilation (APRV) in ARDS.
The patient populations most likely to benefit from APRV.
Key published evidence that informs our use of APRV in critical care.
An expert approach to managing a patient with APRV.
Next steps in research that will direct our understanding of the use of APRV in pediatric critical care.

About our Guest:

Dr. Palen Mallory is an assistant professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. She completed medical school at Virginia Commonwealth University, a pediatric residency at Emory University, and a critical care fellowship at Vanderbilt University. She is interested in respiratory care research, including ECMO, respiratory failure, and ARDS.

Selected References:

Mallory, P., & Cheifetz, I. (2020). A comprehensive review of the use and understanding of airway pressure release ventilation. Expert Review of Respiratory Medicine, 14(3), 307–315. https://doi.org/10.1080/17476348.2020.1708719
Frawley, P. M., & Habashi, N. M. (2004). Airway pressure release ventilation and pediatrics: Theory and practice. Critical Care Nursing Clinics of North America, 16(3 SPEC. ISS.), 337–348. https://doi.org/10.1016/J.CCELL.2004.04.003
Fredericks, A. S., Bunker, M. P., Gliga, L. A., Ebeling, C. G., Ringqvist, J. R. B., Heravi, H., Manley, J., Valladares, J., & Romito, B. T. (2020). Airway Pressure Release Ventilation: A Review of the Evidence, Theoretical Benefits, and Alternative Titration Strategies. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 14. https://doi.org/10.1177/1179548420903297
APRV Guideline - EMCrit Project. (n.d.). Retrieved March 30, 2025, from https://emcrit.org/squirt/aprv/
Andrews P, Shiber J, Madden M, Nieman GF, Camporota L, Habashi NM. Myths and Misconceptions of Airway Pressure Release Ventilation: Getting Past the Noise and on to the Signal. Front Physiol. 2022 Jul 25;13:928562. doi: 10.3389/fphys.2022.928562. PMID: 35957

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Learning Objectives:

By the end of this series, listeners should be able to discuss:

The physiologic rationale supporting the use of airway pressure release ventilation (APRV) in ARDS.
The patient populations most likely to benefit from APRV.
Key published evidence that informs our use of APRV in critical care.
An expert approach to managing a patient with APRV.
Next steps in research that will direct our understanding of the use of APRV in pediatric critical care.

About our Guest:

Dr. Palen Mallory is an assistant professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. She completed medical school at Virginia Commonwealth University, a pediatric residency at Emory University, and a critical care fellowship at Vanderbilt University. She is interested in respiratory care research, including ECMO, respiratory failure, and ARDS.

Selected References:

Mallory, P., & Cheifetz, I. (2020). A comprehensive review of the use and understanding of airway pressure release ventilation. Expert Review of Respiratory Medicine, 14(3), 307–315. https://doi.org/10.1080/17476348.2020.1708719
Frawley, P. M., & Habashi, N. M. (2004). Airway pressure release ventilation and pediatrics: Theory and practice. Critical Care Nursing Clinics of North America, 16(3 SPEC. ISS.), 337–348. https://doi.org/10.1016/J.CCELL.2004.04.003
Fredericks, A. S., Bunker, M. P., Gliga, L. A., Ebeling, C. G., Ringqvist, J. R. B., Heravi, H., Manley, J., Valladares, J., & Romito, B. T. (2020). Airway Pressure Release Ventilation: A Review of the Evidence, Theoretical Benefits, and Alternative Titration Strategies. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 14. https://doi.org/10.1177/1179548420903297
APRV Guideline - EMCrit Project. (n.d.). Retrieved March 30, 2025, from https://emcrit.org/squirt/aprv/
Andrews P, Shiber J, Madden M, Nieman GF, Camporota L, Habashi NM. Myths and Misconceptions of Airway Pressure Release Ventilation: Getting Past the Noise and on to the Signal. Front Physiol. 2022 Jul 25;13:928562. doi: 10.3389/fphys.2022.928562. PMID: 35957

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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We are so thankful for help from our guests:

Melissa (MJ) Sacco, MD

Andrew Parsons, MD

Learning Objective:

By the end of this podcast, listeners should be able to develop an expert-guided approach to identifying and helping trainees improve deficits in diagnostic reasoning, complex decision-making, and effective communication of complicated clinical situations within the healthcare team.

References:

Parsons AS, Wijesekera TP, Rencic JJ. The Management Script: A Practical Tool for Teaching Management Reasoning. Acad Med. 2020 Aug;95(8):1179-1185.

Peterson BD, Magee CD, Martindale JR, Dreicer JJ, Mutter MK, Young G, Sacco MJ, Parsons LC, Collins SR, Warburton KM, Parsons AS. REACT: Rapid Evaluation Assessment of Clinical Reasoning Tool. J Gen Intern Med. 2022 Jul;37(9):2224-2229.

Want to learn more, check out Dr. Parson's book: Clinical Reasoning: Coaching the Struggling Medical Learner

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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About our Guest:

Dr. Omar Alibrahim is a professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. He completed his Pediatric Residency and Chief Residency at St. Joseph's Children's Hospital, followed by Pediatric Critical Care Fellowship at the University of Buffalo. He served as the Pediatric Critical Care Division chief, the PICU Medical Director, and the PCCM fellowship Director in Buffalo, NY, for more than 8 years, during which he worked with the pulmonology and respiratory therapy divisions to develop a negative pressure ventilation program for acute respiratory failure. In 2021 Dr. Alibrahim was recruited to Duke Children's Hospital and now serves as the PICU Medical Director and the program director for the Pediatric Critical Care Fellowship.

Learning Objectives:

By the end of this podcast series, listeners should be able to:

Critique the physiologic rationale for negative pressure ventilation (NPV) in acute respiratory failure.
Understand the experience of introducing a novel form of respiratory support in a PICU.
Describe the stepwise escalation of NPV settings often used in acute respiratory failure.

References:

Derusso, M., Miller, A. G., Caccamise, M., & Alibrahim, O. (2024). Negative-Pressure Ventilation in the Pediatric ICU. Respiratory Care, 69(3), 354–365. https://doi.org/10.4187/RESPCARE.11193
Hassinger AB, Breuer RK, Nutty K, Ma CX, Al Ibrahim OS. Negative-Pressure Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2017 Dec;62(12):1540-1549. doi: 10.4187/respcare.05531. Epub 2017 Aug 31. PMID: 28860332.
Deshpande SR, Maher KO. Long term negative pressure ventilation: Rescue for the failing fontan? World J Cardiol. 2014 Aug 26;6(8):861-4. doi: 10.4330/wjc.v6.i8.861. PMID: 25228965; PMCID: PMC4163715.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

About our Guest:

Dr. Omar Alibrahim is a professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. He completed his Pediatric Residency and Chief Residency at St. Joseph's Children's Hospital, followed by Pediatric Critical Care Fellowship at the University of Buffalo. He served as the Pediatric Critical Care Division chief, the PICU Medical Director, and the PCCM fellowship Director in Buffalo, NY, for more than 8 years, during which he worked with the pulmonology and respiratory therapy divisions to develop a negative pressure ventilation program for acute respiratory failure. In 2021 Dr. Alibrahim was recruited to Duke Children's Hospital and now serves as the PICU Medical Director and the program director for the Pediatric Critical Care Fellowship.

Learning Objectives:

By the end of this podcast series, listeners should be able to:

Critique the physiologic rationale for negative pressure ventilation (NPV) in acute respiratory failure.
Understand the experience of introducing a novel form of respiratory support in a PICU.
Describe the stepwise escalation of NPV settings often used in acute respiratory failure.

References:

Derusso, M., Miller, A. G., Caccamise, M., & Alibrahim, O. (2024). Negative-Pressure Ventilation in the Pediatric ICU. Respiratory Care, 69(3), 354–365. https://doi.org/10.4187/RESPCARE.11193
Hassinger AB, Breuer RK, Nutty K, Ma CX, Al Ibrahim OS. Negative-Pressure Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2017 Dec;62(12):1540-1549. doi: 10.4187/respcare.05531. Epub 2017 Aug 31. PMID: 28860332.
Deshpande SR, Maher KO. Long term negative pressure ventilation: Rescue for the failing fontan? World J Cardiol. 2014 Aug 26;6(8):861-4. doi: 10.4330/wjc.v6.i8.861. PMID: 25228965; PMCID: PMC4163715.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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About our Guest:

Kyle Rehder, MD, is a Professor of Pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital, where he serves as the Vice-Chair of Pediatric Education. He completed his medical school, residency, and chief residency at UNC-Chapel Hill, followed by his fellowship at Duke University. His research is focused on team development and evaluation of advanced respiratory support in the PICU.

Learning Objective:

Develop an expert-based approach to diagnosing and managing common presentations of patient-ventilator asynchrony in the PICU.

References:

Flynn, B. C., Miranda, H. G., Mittel, A. M., & Moitra, V. K. (2022). Stepwise Ventilator Waveform Assessment to Diagnose Pulmonary Pathophysiology. Anesthesiology, 137(1), 85–92. https://doi.org/10.1097/ALN.0000000000004220

Patient-Ventilator Dyssynchrony • LITFL • CCC Ventilation

Citation:

Rehder K, Hodges Z, Shanklin A. Patient-Ventilator Asynchrony. PedsCrit. Online Podcast. 04/2025. https://www.pedscrit.com/patient-ventilator-asynchrony-with-dr-kyle-rehder/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Thanks to Dr. Abhinav Totapally who is a pediatric intensivist at Nicklaus Children's Hospital in Miami and Dr. Brian Bridges, the Division Chief of Pediatric Critical Care Medicine at the Medical University of South Carolina in Charleston for joining us for this series.

Check out their paper published in PCCM in January 2025

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The rationale supporting and the limitations of using VA ECMO for children with refractory septic shock.
Patient selection in the use of VA ECMO for children with refractory septic shock.
The benefits and risks of common cannulation strategies for VA ECMO in children with refractory septic shock.
An expert approach to supporting children with refractory septic shock on VA ECMO.

Reference:

Totapally A, Stark R, Danko M, Chen H, Altheimer A, Hardison D, Malone MP, Zivick E, Bridges B. Central or Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Pediatric Sepsis: Outcomes Comparison in the Extracorporeal Life Support Organization Dataset, 2000-2021. Pediatr Crit Care Med. 2025 Jan 23.

Citation: Totapally A, Bridges B, Shanklin A, Hodges Z. VA ECMO in Refractory Septic Shock. PedsCrit. Online Podcast. 03/2025. https://www.pedscrit.com/va-ecmo-in-refractory-septic-shock-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Thanks to Dr. Abhinav Totapally who is a pediatric intensivist at Nicklaus Children's Hospital in Miami and Dr. Brian Bridges, the Division Chief of Pediatric Critical Care Medicine at the Medical University of South Carolina in Charleston for joining us for this series.

Check out their paper published in PCCM in January 2025

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The rationale supporting and the limitations of using VA ECMO for children with refractory septic shock.
Patient selection in the use of VA ECMO for children with refractory septic shock.
The benefits and risks of common cannulation strategies for VA ECMO in children with refractory septic shock.
An expert approach to supporting children with refractory septic shock on VA ECMO.

Reference:

Totapally A, Stark R, Danko M, Chen H, Altheimer A, Hardison D, Malone MP, Zivick E, Bridges B. Central or Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Pediatric Sepsis: Outcomes Comparison in the Extracorporeal Life Support Organization Dataset, 2000-2021. Pediatr Crit Care Med. 2025 Jan 23.

Citation: Totapally A, Bridges B, Shanklin A, Hodges Z. VA ECMO in Refractory Septic Shock. PedsCrit. Online Podcast. 03/2025. https://www.pedscrit.com/va-ecmo-in-refractory-septic-shock-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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About our guest:

Ilyse Genser is a pediatric neurologist and the associate program director of the pediatric neurology combined residency program at Children's National Hospital. She is originally from Westchester, New York, where she attended medical school at New York Medical College. She then completed her general pediatrics training at Brown University in Providence, Rhode Island, and came to Washington, D.C., to complete her child neurology training at Children's National Hospital.

Learning Objective:

Develop an expert-guided approach to choosing appropriate neuroimaging techniques for critically ill children.

References:

Shulman, J. G., & Abdalkader, M. (2023). Imaging of Central Nervous System Ischemia. http://journals.lww.com/continuum
Hakimi, R. (2023). Imaging of Central Nervous System Hemorrhage. http://journals.lww.com/continuum
Jordan, J. T., & Gerstner, E. R. (2023). Imaging of Brain Tumors. http://journals.lww.com/continuum
Barnette, A. R., Horbar, J. D., Soll, R. F., Pfister, R. H., Nelson, K. B., Kenny, M. J., Raju, T. N. K., Bingham, P. M., & Inder, T. E. (2014). Neuroimaging in the Evaluation of Neonatal Encephalopathy. PEDIATRICS, 133(6), e1508–e1517. https://doi.org/10.1542/peds.2013-4247

Citation: Genser I, Hodges Z, Shanklin A. Neuroimaging for the Pediatric Intensivist. PedsCrit. Online Podcast. 03/2025. https://www.pedscrit.com/neuroimaging-for-the-pediatric-intensivist-with-dr-ilyse-genser-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

About our guest:

Ilyse Genser is a pediatric neurologist and the associate program director of the pediatric neurology combined residency program at Children's National Hospital. She is originally from Westchester, New York, where she attended medical school at New York Medical College. She then completed her general pediatrics training at Brown University in Providence, Rhode Island, and came to Washington, D.C., to complete her child neurology training at Children's National Hospital.

Learning Objective:

Develop an expert-guided approach to choosing appropriate neuroimaging techniques for critically ill children.

References:

Shulman, J. G., & Abdalkader, M. (2023). Imaging of Central Nervous System Ischemia. http://journals.lww.com/continuum
Hakimi, R. (2023). Imaging of Central Nervous System Hemorrhage. http://journals.lww.com/continuum
Jordan, J. T., & Gerstner, E. R. (2023). Imaging of Brain Tumors. http://journals.lww.com/continuum
Barnette, A. R., Horbar, J. D., Soll, R. F., Pfister, R. H., Nelson, K. B., Kenny, M. J., Raju, T. N. K., Bingham, P. M., & Inder, T. E. (2014). Neuroimaging in the Evaluation of Neonatal Encephalopathy. PEDIATRICS, 133(6), e1508–e1517. https://doi.org/10.1542/peds.2013-4247

Citation: Genser I, Hodges Z, Shanklin A. Neuroimaging for the Pediatric Intensivist. PedsCrit. Online Podcast. 03/2025. https://www.pedscrit.com/neuroimaging-for-the-pediatric-intensivist-with-dr-ilyse-genser-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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About our Guest:

Dr. Philip C. Spinella is a professor in the Departments of Surgery and Critical Care Medicine and the Director of the Trauma and Transfusion Medicine Research Center at the University of Pittsburgh. He also co-founded the THOR network for trauma and hemostasis research and has as been involved with multiple nationally-funded research programs.

References:

Use of whole blood in pediatric trauma: a narrative review - PubMed (nih.gov)

Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during Operation Iraqi Freedom at a U.S. combat support hospital - PubMed (nih.gov)

Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative - PubMed (nih.gov)

Whole Blood Transfusion - PubMed (nih.gov)

Pediatric traumatic hemorrhagic shock consensus conference recommendations - PubMed (nih.gov)

Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial - PubMed (nih.gov)

Precision Platelet Transfusion Medicine is Needed to Improve Outcomes - PubMed (nih.gov)

Just chill—it's worth it! (wiley.com)

Citation: Spinella P, Hodges Z, Shanklin A. From the Battlefield to the Bedside: The Past, Present, and Future of Blood Product Resuscitation. PedsCrit. Online Podcast. 02/2025. https://www.pedscrit.com/from-the-battlefield-to-the-bedside-the-past-present-and-future-of-blood-product-resuscitation-wi/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

About our Guest:

Dr. Philip C. Spinella is a professor in the Departments of Surgery and Critical Care Medicine and the Director of the Trauma and Transfusion Medicine Research Center at the University of Pittsburgh. He also co-founded the THOR network for trauma and hemostasis research, and has as been involved with multiple nationally-funded research programs.

References:

Use of whole blood in pediatric trauma: a narrative review - PubMed (nih.gov)

Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during Operation Iraqi Freedom at a U.S. combat support hospital - PubMed (nih.gov)

Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative - PubMed (nih.gov)

Whole Blood Transfusion - PubMed (nih.gov)

Pediatric traumatic hemorrhagic shock consensus conference recommendations - PubMed (nih.gov)

Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial - PubMed (nih.gov)

Precision Platelet Transfusion Medicine is Needed to Improve Outcomes - PubMed (nih.gov)

Just chill—it's worth it! (wiley.com)

Citation: Spinella P, Hodges Z, Shanklin A. From the Battlefield to the Bedside: The Past, Present, and Future of Blood Product Resuscitation. PedsCrit. Online Podcast. 02/2025. https://www.pedscrit.com/from-the-battlefield-to-the-bedside-the-past-present-and-future-of-blood-product-resuscitation-wi/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Article:

Olson EM, Sanborn DM, Dyster TG, Kelm DJ, Murray SG, Santhosh L, DesJardin JT. Gender Disparities in Critical Care Procedure Training of Internal Medicine Residents. ATS Sch. 2023 Feb 13;4(2):164-176. doi: 10.34197/ats-scholar.2022-0025OC. PMID: 37538076; PMCID: PMC10394715. About our Guests:

Dr. Emily Olson is a pulmonary and critical care medicine fellow at Northwestern Feinberg School of Medicine. She attended medical school at the University of Wisconsin School of Medicine and completed her internal medicine residency at Mayo Clinic in Rochester, Minnesota. In addition to her work on gender disparities in procedural training, Dr. Olson is interested in clinical feedback and transitions in medical education.

Dr. Lekshmi Santhosh is an Associate Professor of Medicine in the Division of Pulmonary/Critical Care Medicine and the Division of Hospital Medicine at UCSF. She practices in the MICU, neuro ICU, on the Internal Medicine teaching wards, and at the Pulmonary Outpatient Faculty Practice at UCSF. Dr. Santhosh serves as the Curriculum APD for the Internal Medicine Residency and is an Associate Program Director of the Pulmonary and Critical Care Medicine Fellowship.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define ‘mixed methods’ in a research context.
Explain why a researcher might choose focus groups instead of individual interviews for qualitative assessment.
Discuss factors contributing to implicit bias in procedural opportunities for trainees.
Explain how implicit bias in educational opportunities might lead to a ‘leaky pipeline’ for competitive subspecialties.
Identify ways to truncate their implicit bias when offering procedures to trainees.

References:

Olson EM, Sanborn DM, Dyster TG, Kelm DJ, Murray SG, Santhosh L, DesJardin JT. Gender Disparities in Critical Care Procedure Training of Internal Medicine Residents. ATS Sch. 2023 Feb 13;4(2):164-176. doi: 10.34197/ats-scholar.2022-0025OC. PMID: 37538076; PMCID: PMC10394715.
Olson EM, Kennedy CC, Kelm DJ. Assessment of Gender Parity: Leadership Representation in Pulmonary and Critical Care Medicine. J Womens Health (Larchmt). 2022 Mar;31(3):439-446. doi: 10.1089/jwh.2020.8982. Epub 2021 May 5.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. Dr. Kudchadkar is also the lead PI for the "PICU Up!" study, a 10-site randomized trial of a multifaceted early mobility program for critically ill children.

In this episode, Dr. Kuchadkar shares her path from her general pediatrics residency at Hopkins to running a large multi-center trial as a dual-trained pediatric intensivist and anesthesiologist.

Citation: Kudchadkar S, Hodges Z, Shanklin A. Building a Research Career. PedsCrit. Online Podcast. 01/2025. https://www.pedscrit.com/building-a-research-career-with-dr-sapna-kudchadkar-part-2/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. She completed her training in pediatrics, pediatric intensive care, anesthesiology, and pediatric anesthesiology at Johns Hopkins Children’s Center and the Johns Hopkins Hospital, during which she also received her Ph.D. in clinical investigation at the Johns Hopkins Bloomberg School of Public Health. Dr. Kudchadkar is now the lead PI for the "PICU Up!" study, a 10-site randomized trial of a multifaceted early mobility program for critically ill children.

Learning Objectives:By the end of this podcast, listeners should be able to:

Discuss the best ways to prevent delirium in young children, including sedative medication selection and non-pharmacologic techniques.
Describe the optimal level of sedation for a child who requires invasive mechanical ventilation for acute respiratory failure and the staffing needed to achieve this safely.
Discuss how to obtain hospital resources to support early mobilization and motivate a team to accomplish these goals.

Selected References:

Traube, C., Silver, G., Gerber, L. M., Kaur, S., Mauer, E. A., Kerson, A., Joyce, C., & Greenwald, B. M. (2017). Delirium and Mortality in Critically Ill Children: Epidemiology and Outcomes of Pediatric Delirium. Critical Care Medicine, 45*(5), 891–898. https://doi.org/10.1097/CCM.0000000000002324
Traube, C., Silver, G., Kearney, J., Patel, A., Atkinson, T. M., Yoon, M. J., Halpert, S., Augenstein, J., Sickles, L. E., Li, C., & Greenwald, B. (2014). Cornell Assessment of Pediatric Delirium. Critical Care Medicine, 42(3), 656–663. https://doi.org/10.1097/CCM.0b013e3182a66b76
Wieczorek B, Ascenzi J, Kim Y, Lenker H, Potter C, Shata NJ, Mitchell L, Haut C, Berkowitz I, Pidcock F, Hoch J, Malamed C, Kravitz T, Kudchadkar SR. PICU Up!: Impact of a Quality Improvement Intervention to Promote Early Mobilization in Critically Ill Children. Pediatr Crit Care Med. 2016 Dec;17(12):e559-e566. doi: 10.1097/PCC.0000000000000983. PMID: 27759596; PMCID: PMC5138131.

Citation: Kudchadkar S, Hodges Z, Shanklin A. An Expert Approach to Sedation and Early Mobility. PedsCrit. Online Podcast. 01/2025.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Kristina Betters, MD is an Associate Professor of Pediatrics in the division of Critical Care Medicine at Vanderbilt University and a pediatric intensivist at Monroe Carell Jr. Children’s Hospital. Dr. Betters' research interests are focused on early mobility, rehabilitation of the ICU patient, sedation, and delirium in critically ill children. She was an author of the 2022 SCCM PANDEM guidelines.

Brooke Light, MD is a pediatric resident physician at Prisma Health in Greenville, SC. Prior to residency, she completed her MD at the Medical University of South Carolina. She is (obviously) an aspiring pediatric intensivist, and we are so happy she reached out to coordinate this episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The rationale supporting the use of an ICU liberation bundle.
Key components of the A to F ICU liberation bundle.
An expert’s approach to implementing the A to F ICU liberation bundle

References:

Smith et al. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatr Crit Care Med. 2022 Feb 1;23(2):e74-e110.
Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017 Apr;33(2):225-243.
Curley et al; RESTORE Study Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators Network. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. JAMA. 2015 Jan 27;313(4):379-89.
Madden K, Wolf M, Tasker RC, Figueroa J, McCracken C, Hall M, Kamat P. Antipsychotic Drug Prescription in Pediatric Intensive Care Units: A 10-Year U.S. Retrospective Database Study. J Pediatr Intensive Care. 2021 Oct 22;13(1):46-54.

Citation: Betters K, Light B, Shanklin A, Hodges Z. ICU Liberation. PedsCrit. Online Podcast. 12/2024. https://www.pedscrit.com/icu-liberation-with-dr-kristina-betters-dr-brooke-light-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Kristina Betters, MD is an Associate Professor of Pediatrics in the division of Critical Care Medicine at Vanderbilt University and a pediatric intensivist at Monroe Carell Jr. Children’s Hospital. Dr. Betters' research interests are focused on early mobility, rehabilitation of the ICU patient, sedation, and delirium in critically ill children. She was an author of the 2022 SCCM PANDEM guidelines.

Brooke Light, MD is a pediatric resident physician at Prisma Health in Greenville, SC. Prior to residency, she completed her MD at the Medical University of South Carolina. She is (obviously) an aspiring pediatric intensivist, and we are so happy she reached out to coordinate this episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The rationale supporting the use of an ICU liberation bundle.
Key components of the A to F ICU liberation bundle.
An expert’s approach to implementing the A to F ICU liberation bundle

References:

Smith et al. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatr Crit Care Med. 2022 Feb 1;23(2):e74-e110.
Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017 Apr;33(2):225-243.
Curley et al; RESTORE Study Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators Network. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. JAMA. 2015 Jan 27;313(4):379-89.
Madden K, Wolf M, Tasker RC, Figueroa J, McCracken C, Hall M, Kamat P. Antipsychotic Drug Prescription in Pediatric Intensive Care Units: A 10-Year U.S. Retrospective Database Study. J Pediatr Intensive Care. 2021 Oct 22;13(1):46-54.

Citation: Betters K, Light B, Shanklin A, Hodges Z. ICU Liberation. PedsCrit. Online Podcast. 12/2024. https://www.pedscrit.com/icu-liberation-with-dr-kristina-betters-dr-brooke-light-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Matthew A. Borgman, M.D. is a Professor of Pediatrics in the Division of Pediatric Critical Care at the University of Texas Southwestern. Dr. Borgman graduated from Uniformed Services University (USU), he completed Pediatric Residency at Brooke Army Medical Center in 2007, followed by a fellowship in Critical Care at Boston Children’s Hospital. He is a prolific author in pediatric trauma management which has helped redefine the care of injured children. He is also the former national chair of the Pediatric Trauma Society Research Committee and has co-authored the 2022 Pediatric Traumatic Hemorrhagic Shock Consensus Conference Recommendations.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define pediatric hemorrhagic shock and massive transfusion.
Develop a guideline-based clinical approach to managing a child with hemorrhagic shock.
Explore an expert’s approach to managing a child with hemorrhagic shock where the evidence might not be clear.

References:

Russell et al. Pediatric traumatic hemorrhagic shock consensus conference recommendations. J Trauma Acute Care Surg. 2023 Jan 1;94(1S Suppl 1):S2-S10.
Spinella et al. Transfusion Ratios and Deficits in Injured Children With Life-Threatening Bleeding. Pediatr Crit Care Med. 2022 Apr 1;23(4):235-244.
Gaines et al. Low Titer Group O Whole Blood In Injured Children Requiring Massive Transfusion. Ann Surg. 2023 Apr 1;277(4):e919-e924.
Roberts et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013 Mar;17(10):1-79.
Dewan et al. CRASH-3 - tranexamic acid for the treatment of significant traumatic brain injury: study protocol for an international randomized, double-blind, placebo-controlled trial. Trials. 2012 Jun 21;13:87.
Spinella et al. Survey of transfusion policies at US and Canadian children's hospitals in 2008 and 2009. Transfusion. 2010 Nov;50(11):2328-35.
MATIC-2: https://classic.clinicaltrials.gov/ct2/show/NCT06070350

Citation: Borgman M, Shanklin A, Hodges Z. Hemorrhagic Shock. PedsCrit. Online Podcast. 11/2024.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Bill Bortcosh received his Doctorate of Medicine from Albany Medical School, NY. He completed his pediatric residency at the University of Massachusetts Medical School followed by pediatric critical care fellowship at Massachusetts General Hospital.
Learning Objectives:

By the end of this podcast series, listeners should be able to discuss:

Why critical evaluation of a patient’s acid-base status can be useful and practical in the acute care setting
The basic pathophysiology of each acid-base disturbance
The definition of an anion gap and how to use it as a screening tool
The use of Winter’s formula to identify a respiratory acidosis or alkalosis
The utility of the delta-delta to identify additional metabolic acidosis or alkalosis

Link to Acid/Base Handout

References

Carmody JB, Norwood VF. A clinical approach to paediatric acid-base disorders. Postgrad Med J. 2012;88(1037):143-51.
Carmody JB, Norwood VF. Paediatric acid-base disorders: A case-based review of procedures and pitfalls. Paediatr Child Health. 2013;18(1):29-32.
Emmett M. Approach to the Patient With a Negative Anion Gap. Am J Kidney Dis. 2016;67(1):143-50.
Luke RG, Galla JH. It is chloride depletion alkalosis, not contraction alkalosis. J Am Soc Nephrol. 2012;23(2):204-7.
https://emcrit.org/ibcc/salicylates/

Citation: Bortcosh W, Shanklin A, Hodges Z. Acid-Base Diagnosis & Clinical Approach. PedsCrit Online Podcast. 10/2024. https://www.pedscrit.com/acid-base-diagnosis-clinical-approach-with-dr-bill-bortcosh-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Bill Bortcosh received his Doctorate of Medicine from Albany Medical School, NY. He completed his pediatric residency at the University of Massachusetts Medical School followed by pediatric critical care fellowship at Massachusetts General Hospital.
Learning Objectives:

By the end of this podcast series, listeners should be able to discuss:

Why critical evaluation of a patient’s acid-base status can be useful and practical in the acute care setting
The basic pathophysiology of each acid-base disturbance
The definition of an anion gap and how to use it as a screening tool
The use of Winter’s formula to identify a respiratory acidosis or alkalosis
The utility of the delta-delta to identify additional metabolic acidosis or alkalosis

Link to Acid/Base Handout

References

Carmody JB, Norwood VF. A clinical approach to paediatric acid-base disorders. Postgrad Med J. 2012;88(1037):143-51.
Carmody JB, Norwood VF. Paediatric acid-base disorders: A case-based review of procedures and pitfalls. Paediatr Child Health. 2013;18(1):29-32.
Emmett M. Approach to the Patient With a Negative Anion Gap. Am J Kidney Dis. 2016;67(1):143-50.
Luke RG, Galla JH. It is chloride depletion alkalosis, not contraction alkalosis. J Am Soc Nephrol. 2012;23(2):204-7.
https://emcrit.org/ibcc/salicylates/

Citation: Bortcosh W, Shanklin A, Hodges Z. Acid-Base Diagnosis & Clinical Approach. PedsCrit Online Podcast. 10/2024. https://www.pedscrit.com/acid-base-diagnosis-clinical-approach-with-dr-bill-bortcosh-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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About our Guest:

Debra Regier, M.D., Ph.D., is the chief of Genetics and Metabolism at Children's National Hospital in Washington, DC. Before transitioning to clinical medicine, Dr. Regier was a biochemist. She came to CNH as a combined pediatric genetics resident and later completed a metabolic fellowship at NIH and served as Children's National's medical genetics program director.

Dr. Regier’s current work in educational outcomes research has led to federal, industry, and philanthropic funding of almost two million dollars. She has received multiple awards for her impact on rare disease education across the country and is the president-elect of the Society of Inherited Metabolic Disorders.

Learning Objectives:

By the end of this podcast, listeners should be able to:

List the three main metabolic pathways and describe how they work together to make ATP
Describe the science behind the main diagnostic tests for inborn errors of metabolism
Explain the presenting symptoms and initial management of common, life-threatening inborn errors of metabolism.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

About our Guest:

Debra Regier, M.D., Ph.D., is the chief of Genetics and Metabolism at Children's National Hospital in Washington, DC. Before transitioning to clinical medicine, Dr. Regier was a biochemist. She came to CNH as a combined pediatric genetics resident and later completed a metabolic fellowship at NIH and served as Children's National's medical genetics program director.

Dr. Regier’s current work in educational outcomes research has led to federal, industry, and philanthropic funding of almost two million dollars. She has received multiple awards for her impact on rare disease education across the country and is the president-elect of the Society of Inherited Metabolic Disorders.

Learning Objectives:

By the end of this podcast, listeners should be able to:

List the three main metabolic pathways and describe how they work together to make ATP
Describe the science behind the main diagnostic tests for inborn errors of metabolism
Explain the presenting symptoms and initial management of common, life-threatening inborn errors of metabolism.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Kristen Smith is the PICU medical director, critical care fellowship program director, and director of the nurse practitioner program at the University of Michigan C.S. Mott Children’s Hospital. She received her medical degree from the University of Toledo and completed her pediatric residency at Akron Children’s Hospital, followed by a critical care fellowship at Johns Hopkins. Dr. Smith’s research is focused on the long-term outcome of Pediatric Intensive Care Unit (PICU) survivors.

Dr. Carly Schmidt is a critical care fellow at the University of Michigan C.S. Mott Children’s Hospital. She received her medical degree from Case Western University and completed her pediatric residency at Brown University, where she also served as chief resident. Carly is interested in the intersection of the PICU and the community via transport medicine, advocacy, and outcomes.

Learning Objectives:

By the end of this podcast, listeners should be able to describe:

Neuroprotective measures that should be provided to all pediatric patients with severe traumatic brain injury (TBI).
An expert, guideline-directed approach to managing a child with increased intracranial pressure due to severe TBI.

Reference:Kochanek PM, Tasker RC, Bell MJ, Adelson PD, Carney N, Vavilala MS, Selden NR, Bratton SL, Grant GA, Kissoon N, Reuter-Rice KE, Wainwright MS. Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies. Pediatr Crit Care Med. 2019 Mar;20(3):269-279.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Kristen Smith is the PICU medical director, critical care fellowship program director, and director of the nurse practitioner program at the University of Michigan C.S. Mott Children’s Hospital. She received her medical degree from the University of Toledo and completed her pediatric residency at Akron Children’s Hospital, followed by a critical care fellowship at Johns Hopkins. Dr. Smith’s research is focused on the long-term outcome of Pediatric Intensive Care Unit (PICU) survivors.

Dr. Carly Schmidt is a critical care fellow at the University of Michigan C.S. Mott Children’s Hospital. She received her medical degree from Case Western University and completed her pediatric residency at Brown University, where she also served as chief resident. Carly is interested in the intersection of the PICU and the community via transport medicine, advocacy, and outcomes.

Learning Objectives:

By the end of this podcast, listeners should be able to describe:

Neuroprotective measures that should be provided to all pediatric patients with severe traumatic brain injury (TBI).
An expert, guideline-directed approach to managing a child with increased intracranial pressure due to severe TBI.

Reference:Kochanek PM, Tasker RC, Bell MJ, Adelson PD, Carney N, Vavilala MS, Selden NR, Bratton SL, Grant GA, Kissoon N, Reuter-Rice KE, Wainwright MS. Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies. Pediatr Crit Care Med. 2019 Mar;20(3):269-279.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Stuart Goldstein, MD is a Professor of Pediatrics at the University of Cincinnati, where he serves as the Clark D. West Endowed Chair. He is a practicing pediatric nephrologist at Cincinnati Children’s where he also is the Director for the Center for Acute Care Nephrology and the Medical Director for the Pheresis Service. Dr Goldstein is the Founder and Principal Investigator for the Prospective Pediatric Acute Kidney Injury Research Group and has evaluated novel urinary AKI biomarkers in the pediatric critical care setting.

Dr. Katherine Melink (at time of recording) is currently finishing her residency at Cincinnati Children's Hospital where she was able to conduct research in biomarkers for the prediction of kidney injury in critically ill children (particularly in the CICU). Her exposure to CRRT under physicians like Dr. Goldstein at Cincinnati Children's has served as a motivating factor to participate in this episode! She is excited to start PICU fellowship at Boston Children's Hospital in July.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

CRRT fundamentals, including how it differs from conventional hemodialysis and the rationale for its use in critically ill pediatric patients.
Key differences in ultrafiltration, diffusion, and convection and their clinical applications in CRRT.
Patient selection and indications for CRRT (AKI, fluid overload, toxic metabolite/ingestion among others)
Key evidence guiding use of CRRT in critically ill children.
Components of a CRRT prescription and guiding principles of how to titrate therapy.
Pitfalls and complications of CRRT
Common anticoagulation strategies in CRRT
General principles guiding liberation from CRRT.

Selected references:

Sutherland et al; ADQI 26 Workgroup. Epidemiology of acute kidney injury in children Pediatr Nephrol. 2024 Mar;39(3):919-928. doi: 10.1007/s00467-023-06164-w. Epub 2023 Oct 24.

Basu et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014 Mar;85(3):659-67. doi: 10.1038/ki.2013.349. Epub 2013 Sep 18. PMID: 24048379;

Fuhrman et al; ADQI 26 workgroup. A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children. Pediatr Nephrol. 2024 Mar;39(3):929-939. doi: 10.1007/s00467-023-06133-3. Epub

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Stuart Goldstein, MD is a Professor of Pediatrics at the University of Cincinnati, where he serves as the Clark D. West Endowed Chair. He is a practicing pediatric nephrologist at Cincinnati Children’s where he also is the Director for the Center for Acute Care Nephrology and the Medical Director for the Pheresis Service. Dr Goldstein is the Founder and Principal Investigator for the Prospective Pediatric Acute Kidney Injury Research Group and has evaluated novel urinary AKI biomarkers in the pediatric critical care setting.

Dr. Katherine Melink (at time of recording) is currently finishing her residency at Cincinnati Children's Hospital where she was able to conduct research in biomarkers for the prediction of kidney injury in critically ill children (particularly in the CICU). Her exposure to CRRT under physicians like Dr. Goldstein at Cincinnati Children's has served as a motivating factor to participate in this episode! She is excited to start PICU fellowship at Boston Children's Hospital in July.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

CRRT fundamentals, including how it differs from conventional hemodialysis and the rationale for its use in critically ill pediatric patients.
Key differences in ultrafiltration, diffusion, and convection and their clinical applications in CRRT.
Patient selection and indications for CRRT (AKI, fluid overload, toxic metabolite/ingestion among others)
Key evidence guiding use of CRRT in critically ill children.
Components of a CRRT prescription and guiding principles of how to titrate therapy.
Pitfalls and complications of CRRT
Common anticoagulation strategies in CRRT
General principles guiding liberation from CRRT.

Selected references:

Sutherland et al; ADQI 26 Workgroup. Epidemiology of acute kidney injury in children Pediatr Nephrol. 2024 Mar;39(3):919-928. doi: 10.1007/s00467-023-06164-w. Epub 2023 Oct 24.

Basu et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014 Mar;85(3):659-67. doi: 10.1038/ki.2013.349. Epub 2013 Sep 18. PMID: 24048379;

Fuhrman et al; ADQI 26 workgroup. A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children. Pediatr Nephrol. 2024 Mar;39(3):929-939. doi: 10.1007/s00467-023-06133-3. Epub

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Paul Sue is an associate professor of pediatrics at the Columbia University and Director of the Pediatric Transplant and Immunocompromised Host or “PITCH” Infectious Diseases Program at the Morgan Stanley Children’s Hospital in NY. He completed his pediatric residency at Jacobi Medical Center at the Albert Einstein College of Medicine in the Bronx, and his fellowship in pediatric infectious diseases at Johns Hopkins University in Baltimore. He then moved to UT Southwestern in Dallas TX, where he served as director of Pediatric ICH ID service for the next 8 years, prior to his recent move back to NY. His research interests include the impact of invasive fungal and viral infections in the immunocompromised host, leveraging measures of functional immunity to improve infectious disease outcomes in high-risk patients, and the emergence of community acquired multidrug resistant (MDR) bacterial infections in immunocompromised children.

Sara Dong, MD is an adult and pediatric infectious disease physician at Emory University School of Medicine & Children’s Healthcare of Atlanta, where her clinical focus is transplant and immunocompromised host ID. She earned her MD from the Medical University of South Carolina. She completed her internal medicine and pediatrics (Med-Peds) residency and chief residency years at Ohio State University Wexner Medical Center and Nationwide Children’s Hospital, followed by Med-Peds ID and Medical Education fellowships at Beth Israel Deaconess Medical Center and Boston Children’s Hospital. She is the creator and host of Febrile podcast and learning platform, co-host of the ID Puscast podcast, and the program director for the ID Digital Institute.

Learning Objectives

After listening to this episode on invasive candidemia, learners should be able to discuss:

Treatment of candidemia in a critically-ill immunocompromised patient.
Management of indwelling central catheters in critically-ill patients with candidemia.
The role of immune adjuncts (e.g. G-CSF or granulocyte transfusions) in the management of persistent candidemia in an immunocompromised patient.

References:

https://febrilepodcast.com/

Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update b

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Paul Sue is an associate professor of pediatrics at the Columbia University and Director of the Pediatric Transplant and Immunocompromised Host at the Morgan Stanley Children’s Hospital in NY. He completed his pediatric residency at Jacobi Medical Center at the Albert Einstein College of Medicine in the Bronx, and his fellowship in pediatric infectious diseases at Johns Hopkins University in Baltimore. He then moved to UT Southwestern in Dallas TX, where he served as director of Pediatric ICH ID service for the next 8 years, prior to his recent move back to NY. His research interests include the impact of invasive fungal and viral infections in the immunocompromised host, leveraging measures of functional immunity to improve infectious disease outcomes in high-risk patients, and the emergence of community acquired multidrug resistant (MDR) bacterial infections in immunocompromised children.

Sara Dong, MD is an adult and pediatric infectious disease physician at Emory University School of Medicine & Children’s Healthcare of Atlanta, where her clinical focus is transplant and immunocompromised host ID. She earned her MD from the Medical University of South Carolina. She completed her internal medicine and pediatrics (Med-Peds) residency and chief residency years at Ohio State University Wexner Medical Center and Nationwide Children’s Hospital, followed by Med-Peds ID and Medical Education fellowships at Beth Israel Deaconess Medical Center and Boston Children’s Hospital. She is the creator and host of Febrile podcast and learning platform, co-host of the ID Puscast podcast, and the program director for the ID Digital Institute.

Learning Objectives

After listening to this episode on invasive candidemia, learners should be able to discuss:

Risk factors associated with invasive fungal infections in critically-ill immunocompromised patients.
Common pathogens associated with invasive fungal infections in critically-ill immunocompromised patients.
Principles guiding selection of empiric antifungal agents for critically-ill patients at risk of invasive fungal infections.

References:

https://febrilepodcast.com/

Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Inf

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Chris Horvat is a pediatric intensivist and informaticist at UPMC Children's Hospital of Pittsburgh. He started his academic career at UNC-Chapel Hill where he got his undergraduate and medical degrees, after which he completed a pediatric residency at Seattle Children's Hospital and a pediatric critical care fellowship at UPMC. Dr. Horvat also completed Pittsburgh’s T-32 Postdoctoral Research Fellowship in Pediatric Neurointensive Care through the Safar Center for Resuscitation Research, during which he earned a master’s in health administration (MHA) from the University of Pittsburgh. In his current work, he aims to utilize a combination of electronic health record-derived datasets, pharmaco-kinetic models, and pharmacogenomic insights to develop advanced clinical decision-support tools to help refine the use of potent sedatives and analgesic medications in the pediatric intensive care unit. He also serves as a clinical informatics leader, helping to deploy randomized, embedded, multifactorial, adaptive platform (REMAP) trials across the UPMC system.

Learning Objectives
By the end of this podcast, listeners should be able to:

List the concerns surrounding the pediatric subspecialty workforce and the unique position of PCCM.
Describe the modeling performed for each pediatric subspecialty.
Describe the future of the PCCM workforce, including the job opportunities that current PCCM fellows can expect and the utility of dual boarding in cardiology.

References

Leslie LK, Orr CJ, Turner AL, et al. Child Health and the US Pediatric Subspecialty Workforce: Planning for the Future. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678B
Horvat CM, Hamilton MF, Hall MW, McGuire JK, Mink RB. Child Health Needs and the Pediatric Critical Care Medicine Workforce: 2020–2040. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678G
Fraher E, Knapton A, McCartha E, Leslie LK. Forecasting the Future Supply of Pediatric Subspecialists in the United States: 2020–2040. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678C
Horak R V., Marino BS, Werho DK, et al. Assessment of physician training and prediction of workforce needs in paediatric cardiac intensive care in the United States. Cardiol Young. 2022;32(11):1748-1753. doi:10.1017/S1047951121004893

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Alexander Rotta, MD is a Professor of Pediatrics and the Division Chief of Pediatric Critical Care at Duke University School of Medicine. He is an accomplished intensivist, educator and physician scientist with well over 100 publications with a focus on respiratory care in critically ill children. He authored a review on high-frequency jet ventilation that served as the foundation for today’s episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting the use of high frequency jet ventilation (HFJV).
Patient populations most likely to benefit from HFJV.
Key published evidence that informs our use of HFJV in pediatric critical care.
An expert approach to managing a patient with HFJV.

References:

Cheifetz IM, Rotta AT. High-Frequency Jet Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2021 Feb;66(2):191-198. doi: 10.4187/respcare.08241. Epub 2020 Oct 2. PMID: 33008841.

Miller AG, Scott BL, Gates RM, Haynes KE, Lopez Domowicz DA, Rotta AT. High-Frequency Jet Ventilation in Infants With Congenital Heart Disease. Respir Care. 2021 Nov;66(11):1684-1690. doi: 10.4187/respcare.09186. Epub 2021 Jun 9. PMID: 34108137.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Alexander Rotta, MD is a Professor of Pediatrics and the Division Chief of Pediatric Critical Care at Duke University School of Medicine. He is an accomplished intensivist, educator and physician scientist with well over 100 publications with a focus on respiratory care in critically ill children. He authored a review on high-frequency jet ventilation that served as the foundation for today’s episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting the use of high frequency jet ventilation (HFJV).
Patient populations most likely to benefit from HFJV.
Key published evidence that informs our use of HFJV in pediatric critical care.
An expert approach to managing a patient with HFJV.

References:

Cheifetz IM, Rotta AT. High-Frequency Jet Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2021 Feb;66(2):191-198. doi: 10.4187/respcare.08241. Epub 2020 Oct 2. PMID: 33008841.

Miller AG, Scott BL, Gates RM, Haynes KE, Lopez Domowicz DA, Rotta AT. High-Frequency Jet Ventilation in Infants With Congenital Heart Disease. Respir Care. 2021 Nov;66(11):1684-1690. doi: 10.4187/respcare.09186. Epub 2021 Jun 9. PMID: 34108137.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Steven Loscalzo, MD, FAAP is an Attending Physician in the Division of Pediatric Critical Care Medicine and an Assistant Professor of Anesthesiology, Critical Care, and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. He completed his residency and chief residency in Pediatrics at St. Christopher’s Hospital for Children, followed by a critical care fellowship at the Children’s Hospital of Philadelphia. He is now an attending physician in the Division of Critical Care Medicine at Children's Hospital of Philadelphia.

Elorm Avakame, MD, MPP recently completed his Pediatric Critical Care Medicine fellowship at New York-Presbyterian Hospital/Columbia University Medical Center. His areas of professional interest include clinical teaching in the ICU and mentoring and professional identity formation. This August, he will begin his faculty career as an attending physician in the Department of Anesthesiology and Critical Care Medicine at Children's Hospital of Philadelphia.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define “emotional intelligence” and discuss relevant conceptual frameworks.
Identify examples of emotional intelligence competencies.
Describe existing data supporting the importance of emotional intelligence in clinical practice.
Discuss strategies for teaching emotional intelligence competencies in critical care training.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Ayse Akcan Arikan, MD is a dual trained pediatric intensivist and nephrologist and an Associate Professor of Pediatrics with tenure at Baylor College of Medicine. She is the Associate Chief (Research) of the Division of Critical Care Medicine. Dr Arikan is a clinician-scientist whose research focus is on the recognition and management of acute kidney injury in the critically ill, pharmacokinetics in extracorporeal therapies, management of multiple organ failure, as well as sepsis resuscitation and outcomes. Dr Arikan also serves as the Medical Director of the Critical Care Nephrology and Inpatient Dialysis and the Medical Director of the Extracorporeal Liver Support programs at Texas Children’s Hospital. She is an international leader in pediatric extracorporeal renal and liver support.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The rationale for using extracorporeal liver support in patients with acute liver failure.
The various modalities of extracorporeal liver support and their advantages and disadvantages.
An expert’s approach to utilization of extracorporeal liver support in patients with acute liver failure.

References:

Akcan Arikan, Ayse MD1,2; Srivaths, Poyyapakkam MD1; Himes, Ryan W. MD3; Tufan Pekkucuksen, Naile MD1; Lam, Fong MD2; Nguyen, Trung MD2; Miloh, Tamir MD3; Braun, Michael MD1; Goss, John MD4; Desai, Moreshwar S. MD2. Hybrid Extracorporeal Therapies as a Bridge to Pediatric Liver Transplantation*. Pediatric Critical Care Medicine 19(7):p e342-e349, July 2018. | DOI: 10.1097/PCC.0000000000001546

Mitzner SR. Extracorporeal liver support-albumin dialysis with the Molecular Adsorbent Recirculating System (MARS). Ann Hepatol. 2011 May;10 Suppl 1:S21-8. PMID: 21566251.

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Ayse Akcan Arikan, MD is a dual trained pediatric intensivist and nephrologist and an Associate Professor of Pediatrics with tenure at Baylor College of Medicine. She is the Associate Chief (Research) of the Division of Critical Care Medicine. Dr Arikan is a clinician-scientist whose research focus is on the recognition and management of acute kidney injury in the critically ill, pharmacokinetics in extracorporeal therapies, management of multiple organ failure, as well as sepsis resuscitation and outcomes. Dr Arikan also serves as the Medical Director of the Critical Care Nephrology and Inpatient Dialysis and the Medical Director of the Extracorporeal Liver Support programs at Texas Children’s Hospital. She is an international leader in pediatric extracorporeal renal and liver support.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The rationale for using extracorporeal liver support in patients with acute liver failure.
The various modalities of extracorporeal liver support and their advantages and disadvantages.
An expert’s approach to utilization of extracorporeal liver support in patients with acute liver failure.

References:

Akcan Arikan, Ayse MD1,2; Srivaths, Poyyapakkam MD1; Himes, Ryan W. MD3; Tufan Pekkucuksen, Naile MD1; Lam, Fong MD2; Nguyen, Trung MD2; Miloh, Tamir MD3; Braun, Michael MD1; Goss, John MD4; Desai, Moreshwar S. MD2. Hybrid Extracorporeal Therapies as a Bridge to Pediatric Liver Transplantation*. Pediatric Critical Care Medicine 19(7):p e342-e349, July 2018. | DOI: 10.1097/PCC.0000000000001546

Mitzner SR. Extracorporeal liver support-albumin dialysis with the Molecular Adsorbent Recirculating System (MARS). Ann Hepatol. 2011 May;10 Suppl 1:S21-8. PMID: 21566251.

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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James E. Squires MD, MS, is a pediatric hepatologist and is certified in pediatric gastroenterology and advanced/transplant hepatology by the American Board of Pediatrics. He is an Associate Professor in Pediatrics and is the Associate Director of Hepatology and the Program Director for the Advanced/Transplant Hepatology Fellowship at the University of Pittsburgh School of Medicine. He received his medical degree from University of Texas in Galveston and completed his residency followed by his fellowships in Pediatric Gastroenterology and Advanced/Transplant Hepatology at Cincinnati Children’s Hospital Medical Center.

Dr. Maria Pliakas is a critical care fellow at the University of Michigan, she is interested in the way we can best sedate patients with acute liver failure as we bridge them to transplant. We are SO grateful that she reached out to us, and that she was able to recruit Dr. Squires for this episode.

References:

Hobby recommendation: https://www.platformtennis.org/

Squires JE, Alonso EM, Ibrahim SH, Kasper V, Kehar M, Martinez M, Squires RH. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure. J Pediatr Gastroenterol Nutr. 2022 Jan 1;74(1):138-158. doi: 10.1097/MPG.0000000000003268. PMID: 34347674.

Squires JE, Rudnick DA, Hardison RM, Horslen S, Ng VL, Alonso EM, Belle SH, Squires RH. Liver Transplant Listing in Pediatric Acute Liver Failure: Practices and Participant Characteristics. Hepatology. 2018 Dec;68(6):2338-2347. doi: 10.1002/hep.30116. Epub 2018 Nov 1. PMID: 30070372; PMCID: PMC6275095.

https://www.pedsalf.com/

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

James E. Squires MD, MS, is a pediatric hepatologist and is certified in pediatric gastroenterology and advanced/transplant hepatology by the American Board of Pediatrics. He is an Associate Professor in Pediatrics and is the Associate Director of Hepatology and the Program Director for the Advanced/Transplant Hepatology Fellowship at the University of Pittsburgh School of Medicine. He received his medical degree from University of Texas in Galveston and completed his residency followed by his fellowships in Pediatric Gastroenterology and Advanced/Transplant Hepatology at Cincinnati Children’s Hospital Medical Center.

Dr. Maria Pliakas is a critical care fellow at the University of Michigan, she is interested in the way we can best sedate patients with acute liver failure as we bridge them to transplant. We are SO grateful that she reached out to us, and that she was able to recruit Dr. Squires for this episode.

References:

Hobby recommendation: https://www.platformtennis.org/

Squires JE, Alonso EM, Ibrahim SH, Kasper V, Kehar M, Martinez M, Squires RH. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure. J Pediatr Gastroenterol Nutr. 2022 Jan 1;74(1):138-158. doi: 10.1097/MPG.0000000000003268. PMID: 34347674.

Squires JE, Rudnick DA, Hardison RM, Horslen S, Ng VL, Alonso EM, Belle SH, Squires RH. Liver Transplant Listing in Pediatric Acute Liver Failure: Practices and Participant Characteristics. Hepatology. 2018 Dec;68(6):2338-2347. doi: 10.1002/hep.30116. Epub 2018 Nov 1. PMID: 30070372; PMCID: PMC6275095.

https://www.pedsalf.com/

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Martin Kneyber is Chief of the Division of Paediatric Critical Care Medicine at the Beatrix Children’s Hospital, University Medical Center the Netherlands. He is interested in better understanding the respiratory pathophysiology in mechanically ventilated children. His basic science research focuses on ventilator-induced lung injury and its relationship with multiple system organ failure, he is also a principal investigator for PROSpect–Prone and Oscillation pediatric clinical trial.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting the use of high frequency oscillatory ventilation (HFOV).
Patient populations most likely to benefit from HFOV.
Key published evidence that informs our use of HFOV in pediatric critical care.
An expert approach to managing a patient with HFOV.
Next steps in research that will direct our understanding of the use of HFOV in pediatric critical care.

References:
Ferguson ND, Cook DJ, Guyatt GH, Mehta S, Hand L, Austin P, Zhou Q, Matte A, Walter SD, Lamontagne F, Granton JT, Arabi YM, Arroliga AC, Stewart TE, Slutsky AS, Meade MO; OSCILLATE Trial Investigators; Canadian Critical Care Trials Group. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med. 2013 Feb 28;368(9):795-805. doi: 10.1056/NEJMoa1215554. Epub 2013 Jan 22. PMID: 23339639.

de Jager P, Curley MAQ, Cheifetz IM, Kneyber MCJ. Hemodynamic Effects of a High-Frequency Oscillatory Ventilation Open-Lung Strategy in Critically Ill Children With Acquired or Congenital Cardiac Disease. Pediatr Crit Care Med. 2023 Jun 1;24(6):e272-e281. doi: 10.1097/PCC.0000000000003211. Epub 2023 Mar 6. PMID: 36877029; PMCID: PMC10226461.

https://prospect-network.org/

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Martin Kneyber is Chief of the Division of Paediatric Critical Care Medicine at the Beatrix Children’s Hospital, University Medical Center the Netherlands. He is interested in better understanding the respiratory pathophysiology in mechanically ventilated children. His basic science research focuses on ventilator-induced lung injury and its relationship with multiple system organ failure, he is also a principal investigator for PROSpect–Prone and Oscillation pediatric clinical trial.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting the use of high frequency oscillatory ventilation (HFOV).
Patient populations most likely to benefit from HFOV.
Key published evidence that informs our use of HFOV in pediatric critical care.
An expert approach to managing a patient with HFOV.
Next steps in research that will direct our understanding of the use of HFOV in pediatric critical care.

References:
Ferguson ND, Cook DJ, Guyatt GH, Mehta S, Hand L, Austin P, Zhou Q, Matte A, Walter SD, Lamontagne F, Granton JT, Arabi YM, Arroliga AC, Stewart TE, Slutsky AS, Meade MO; OSCILLATE Trial Investigators; Canadian Critical Care Trials Group. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med. 2013 Feb 28;368(9):795-805. doi: 10.1056/NEJMoa1215554. Epub 2013 Jan 22. PMID: 23339639.

de Jager P, Curley MAQ, Cheifetz IM, Kneyber MCJ. Hemodynamic Effects of a High-Frequency Oscillatory Ventilation Open-Lung Strategy in Critically Ill Children With Acquired or Congenital Cardiac Disease. Pediatr Crit Care Med. 2023 Jun 1;24(6):e272-e281. doi: 10.1097/PCC.0000000000003211. Epub 2023 Mar 6. PMID: 36877029; PMCID: PMC10226461.

https://prospect-network.org/

Support the Show.

How to support PedsCrit:Please complete our Listener Feedback Survey

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Thomas Conlon, MD is a pediatric intensivist at the Children's Hospital of Philadelphia, where he also serves as the Director of Pediatric Critical Care Ultrasound. His professional/research interests include clinical and educational outcomes in diagnostic and procedural ultrasound as well as programmatic ultrasound implementation.

Sarah Ginsburg, MD is an Assistant Professor of Pediatrics at the University of Texas Southwestern and pediatric intensivist at Children’s Medical Center Dallas. Her professional & research interests include clinical applications of POCUS in the PICU. She is very active both locally and nationally in improving POCUS skills for pediatric intensivists, including participating in Pediatric Research Collaborative on Critical Ultrasound, a subgroup of PALISI.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Identify the limitations of the physical exam and lab-based data in evaluating shock at the bedside of critically ill children.
Describe how point-of-care ultrasound might provide greater accuracy in our evaluation of complex shock physiology.
Discuss limitations to our ability as critical care physicians to use point-of-care ultrasound in our clinical practice and suggest solutions to overcome commonly encountered barriers.

References:

Lu et al. Recommendations for Cardiac Point-of-Care Ultrasound in Children: A Report from the American Society of Echocardiography. J Am Soc Echocardiogr. 2023 Mar;36(3):265-277. doi: 10.1016/j.echo.2022.11.010. Epub 2023 Jan 23. PMID: 36697294.
Walker et al. Clinical Signs to Categorize Shock and Target Vasoactive Medications in Warm Versus Cold Pediatric Septic Shock. Pediatr Crit Care Med. 2020 Dec;21(12):1051-1058.
Conlon et al. Diagnostic Bedside Ultrasound Program Development in Pediatric Critical Care Medicine: Results of a National Survey. Pediatr Crit Care Med. 2018 Nov;19(11):e561-e568.
Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine. Ann Emerg Med. 2023 Sep;82(3):e115-e155.
Conlon et al. Establishing a risk assessment framework for point-of-care ultrasound. Eur J Pediatr. 2022 Apr;181(4):1449-1457.
https://coreultrasound.com/
https://coreultrasound.com/5ms/
https://www.youtube.com/@perccus

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Thomas Conlon, MD is a pediatric intensivist at the Children's Hospital of Philadelphia, where he also serves as the Director of Pediatric Critical Care Ultrasound. His professional/research interests include clinical and educational outcomes in diagnostic and procedural ultrasound as well as programmatic ultrasound implementation.

Sarah Ginsburg, MD is an Assistant Professor of Pediatrics at the University of Texas Southwestern and pediatric intensivist at Children’s Medical Center Dallas. Her professional & research interests include clinical applications of POCUS in the PICU. She is very active both locally and nationally in improving POCUS skills for pediatric intensivists, including participating in Pediatric Research Collaborative on Critical Ultrasound, a subgroup of PALISI.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Identify the limitations of the physical exam and lab-based data in evaluating shock at the bedside of critically ill children.
Describe how point-of-care ultrasound might provide greater accuracy in our evaluation of complex shock physiology.
Discuss limitations to our ability as critical care physicians to use point-of-care ultrasound in our clinical practice and suggest solutions to overcome commonly encountered barriers.

References:

Lu et al. Recommendations for Cardiac Point-of-Care Ultrasound in Children: A Report from the American Society of Echocardiography. J Am Soc Echocardiogr. 2023 Mar;36(3):265-277. doi: 10.1016/j.echo.2022.11.010. Epub 2023 Jan 23. PMID: 36697294.
Walker et al. Clinical Signs to Categorize Shock and Target Vasoactive Medications in Warm Versus Cold Pediatric Septic Shock. Pediatr Crit Care Med. 2020 Dec;21(12):1051-1058.
Conlon et al. Diagnostic Bedside Ultrasound Program Development in Pediatric Critical Care Medicine: Results of a National Survey. Pediatr Crit Care Med. 2018 Nov;19(11):e561-e568.
Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine. Ann Emerg Med. 2023 Sep;82(3):e115-e155.
Conlon et al. Establishing a risk assessment framework for point-of-care ultrasound. Eur J Pediatr. 2022 Apr;181(4):1449-1457.
https://coreultrasound.com/
https://coreultrasound.com/5ms/
https://www.youtube.com/@perccus

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Congenital Diaphragmatic Hernia with Dr. Yigit Guner & Dr. Amir Ashrafi Part 3

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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By the end of this podcast, listeners should be able to discuss:

The clinically relevant anatomic and physiologic consequences of CDH.
The relevant prenatal evaluation and interventions for unborn babies with CDH.
The core aspects of neonatal resuscitation and cardiopulmonary support for neonates with CDH.
The role of ECMO in neonates with CDH.
The timing, general approach and relevant complications of CDH surgical repair.
The expected long-term outcomes of neonates with CDH.

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The limitations of prior definitions of pediatric sepsis and the rationale for creating the Phoenix Sepsis Criteria.
The methods and key outcomes used for deriving the Phoenix Sepsis Criteria.
How to diagnose sepsis using the Phoenix Sepsis Criteria.
General limitations of the Phoenix Sepsis Criteria.
Next steps in implementing the Phoenix Sepsis Criteria and the direction it provides for future research.

About our Guest:

L. Nelson Sanchez-Pinto, MD, is a Pediatric intensivist at Lurie Children’s Hospital of Chicago, where he is also an Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

Dr. Sanchez-Pinto co-led an international group of researchers in the Society of Critical Care Medicine Pediatric Sepsis Definition Task Force for the Development and Validation of the new Phoenix Criteria for Pediatric Sepsis and Septic Shock that was featured at the recent 2024 SCCM conference.

Support the show

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The limitations of prior definitions of pediatric sepsis and the rationale for creating the Phoenix Sepsis Criteria.
The methods and key outcomes used for deriving the Phoenix Sepsis Criteria.
How to diagnose sepsis using the Phoenix Sepsis Criteria.
General limitations of the Phoenix Sepsis Criteria.
Next steps in implementing the Phoenix Sepsis Criteria and the direction it provides for future research.

About our Guest:

L. Nelson Sanchez-Pinto, MD, is a Pediatric intensivist at Lurie Children’s Hospital of Chicago, where he is also an Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

Dr. Sanchez-Pinto co-led an international group of researchers in the Society of Critical Care Medicine Pediatric Sepsis Definition Task Force for the Development and Validation of the new Phoenix Criteria for Pediatric Sepsis and Septic Shock that was featured at the recent 2024 SCCM conference.

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Ethan Sanford, MD is an Assistant Professor of Anesthesia and Pediatrics at the University of Texas Southwestern in Dallas. He completed his MD at Harvard University followed by Anesthesiology residency at Brigham and Women’s Hospital and pediatric anesthesia fellowship at Boston Children’s Hospital. He then completed a pediatric critical care fellowship here at UTSW. He is board certified in both pediatric anesthesia and pediatric critical care medicine. He works both as a pediatric anesthesiologist and intensivist at UTSW/CMC Dallas.

Learning Objective:By the end of this podcast, listeners should have an improved understanding of the grief experienced by parents at the end of their child's life and be better equipped to care for them in the pediatric intensive care unit.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Reference:Sanford EL. Losing Ceci. JAMA. 2023 May 2;329(17):1451-1452. doi: 10.1001/jama.2023.4747. PMID: 37022705.

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Elizabeth Killien, MD MPH is an Assistant Professor of Pediatrics at the University of Washington and an attending physician in the Pediatric ICU at Seattle Children’s. She earned her MD from Dartmouth Medical School in 2011. She completed her residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at the University of Washington. She underwent additional training in pediatric trauma research at the Harborview Injury Prevention and Research Center in the Pediatric Injury Research Training Program from 2017-2019, and completed her Master of Public Health degree in Epidemiology at the University of Washington in 2019. She is a member of the Society of Critical Care Medicine, Pediatric Acute Lung Injury and Sepsis Investigators, and American Thoracic Society. Her scholarly work focuses on organ failure after traumatic injury and long-term outcomes after critical illness.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.
Recognize common risk factors of post-intensive care syndrome in children.
Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.
Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.
Recall key next steps in post-intensive care syndrome research.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

References:

Manning, Joseph C. RN, PhD1,2,3; Pinto, Neethi P. MD, MS4; Rennick, Janet E. RN, PhD5,6; Colville, Gillian MPhil, CPsychol7; Curley, Martha A. Q. RN, PhD8,9,10. Conceptualizing Post Intensive Care Syndrome in Children—

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Elizabeth Killien, MD MPH is an Assistant Professor of Pediatrics at the University of Washington and an attending physician in the Pediatric ICU at Seattle Children’s. She earned her MD from Dartmouth Medical School in 2011. She completed her residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at the University of Washington. She underwent additional training in pediatric trauma research at the Harborview Injury Prevention and Research Center in the Pediatric Injury Research Training Program from 2017-2019, and completed her Master of Public Health degree in Epidemiology at the University of Washington in 2019. She is a member of the Society of Critical Care Medicine, Pediatric Acute Lung Injury and Sepsis Investigators, and American Thoracic Society. Her scholarly work focuses on organ failure after traumatic injury and long-term outcomes after critical illness.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.
Recognize common risk factors of post-intensive care syndrome in children.
Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.
Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.
Recall key next steps in post-intensive care syndrome research.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

References:

Manning, Joseph C. RN, PhD1,2,3; Pinto, Neethi P. MD, MS4; Rennick, Janet E. RN, PhD5,6; Colville, Gillian MPhil, CPsychol7; Curley, Martha A. Q. RN, PhD8,9,10. Conceptualizing Post Intensive Care Syndrome in Children—

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Alexis Topjian, MD, MSCE is a Professor of Anesthesiology and Critical Care at the University of Pennsylvania. She is an intensivist at the Children’s Hospital of Philadelphia where she also serves as the Fellowship Director of Neurocritical Care, Director of the Pediatric Neurocritical Care Program, and the Director of Faculty Development. She also was the first author on the 2019 Pediatric Post–Cardiac Arrest Care Scientific Statement from the American Heart Association.

Learning Objectives:

By the end of this podcast, listeners should be able to describe:

The clinical characteristics of post-cardiac arrest syndrome.
The general goals and guiding principles of high quality post-cardiac arrest care.
An evidence-based approach to diagnostic testing and monitoring of the post-cardiac arrest patient.
An evidence-based approach to supportive treatment of the post-cardiac arrest patient with an emphasis on targeted temperature management.
Relevant prognostic factors and best practices communicating prognosis to families of children who have suffered a cardiac arrest.

How to support PedsCrit:Please complete our Listener Feedback Survey:
(https://cri-datacap.org/surveys/?s=CDM3NMWL9F3N3DKJ)

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

References:

Topjian AA, de Caen A, Wainwright MS, Abella BS, Abend NS, Atkins DL, Bembea MM, Fink EL, Guerguerian AM, Haskell SE, Kilgannon JH, Lasa JJ, Hazinski MF. Pediatric Post-Cardiac Arrest Care: A Scientific Statement From the American Heart Association. Circulation. 2019 Aug 6;140(6):e194-e233. doi: 10.1161/CIR.0000000000000697. Epub 2019 Jun 27. PMID: 31242751.

Moler et al. Therapeutic

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Alexis Topjian, MD, MSCE is a Professor of Anesthesiology and Critical Care at the University of Pennsylvania. She is an intensivist at the Children’s Hospital of Philadelphia where she also serves as the Fellowship Director of Neurocritical Care, Director of the Pediatric Neurocritical Care Program, and the Director of Faculty Development. She also was the first author on the 2019 Pediatric Post–Cardiac Arrest Care Scientific Statement from the American Heart Association.

Learning Objectives:

By the end of this podcast, listeners should be able to describe:

The clinical characteristics of post-cardiac arrest syndrome.
The general goals and guiding principles of high quality post-cardiac arrest care.
An evidence-based approach to diagnostic testing and monitoring of the post-cardiac arrest patient.
An evidence-based approach to supportive treatment of the post-cardiac arrest patient with an emphasis on targeted temperature management.
Relevant prognostic factors and best practices communicating prognosis to families of children who have suffered a cardiac arrest.

How to support PedsCrit:Please complete our Listener Feedback Survey:
(https://cri-datacap.org/surveys/?s=CDM3NMWL9F3N3DKJ)

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

References:

Topjian AA, de Caen A, Wainwright MS, Abella BS, Abend NS, Atkins DL, Bembea MM, Fink EL, Guerguerian AM, Haskell SE, Kilgannon JH, Lasa JJ, Hazinski MF. Pediatric Post-Cardiac Arrest Care: A Scientific Statement From the American Heart Association. Circulation. 2019 Aug 6;140(6):e194-e233. doi: 10.1161/CIR.0000000000000697. Epub 2019 Jun 27. PMID: 31242751.

Moler et al. Therapeut

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Listener Feedback Survey

Objectives:

After listening to this series of episodes, learners should be able to discuss:

Evidence supporting the use of VV-ECMO in neonatal and pediatric patients with refractory respiratory failure.
The general indications for VV-ECMO in neonates and pediatric patients.
A rationale for choosing cannula size and cannulation site for VV-ECMO in neonates and pediatric patients.
An approach to ensuring proper cannula location and monitoring of a patient supported on VV-ECMO.
An approach to nutrition, sedation and ventilator management for neonates and pediatric patients on VV-ECMO.
An approach to managing recirculation in a patient supported with VV-ECMO.
The rationale and an approach to rehabilitation for patients supported with VV-ECMO.
An approach to weaning VV-ECMO support and liberating patients from the circuit.

About our guest:
Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covid

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition.
Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.
Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation.
Rosner EA e

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Tarif Choudhury is a pediatric cardiac intensivist at Columbia University College of Physicians and Surgeons. After finishing his residency in pediatrics at Cohen Children’s Medical Center, he completed his cardiology fellowship at Lurie Children’s Hospital in Chicago followed by a pediatric critical care fellowship at Morgan Stanley Children’s Hospital at Columbia University School of Medicine. His areas of interest are the impact of clinical simulation to improve team performance, clinical outcomes of PCICU patients and clinical outcomes of patients on mechanical circulatory support in the PCICU.

Dr. Gav Apfel is a CICU hospitalist at Columbia University College of Physicians and Surgeons. He completed his residency training at Columbia University College of Physicians and Surgeons and will be joining the Columbia University’s critical care fellowship program next year. He is interested in pursuing a career in cardiac intensive care.

Objectives
By the end of this podcast series, listeners should be able to:

Strategize how to approach an arrest as the code leader
Recognize the key elements of high-quality CPR and how to optimize perfusion during an arrest
Recall airway management, oxygenation, and ventilation during CPR
Recall different approaches to physiological monitoring during an arrest to guide therapy
Recognize appropriate resuscitation drug administration and timing during CPR
Recall management with manual defibrillation for arrests with a shockable rhythm
Develop approach to determining code duration and when to discontinue CPR

How to support PedsCrit
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Tarif Choudhury is a pediatric cardiac intensivist at Columbia University College of Physicians and Surgeons. After finishing his residency in pediatrics at Cohen Children’s Medical Center, he completed his cardiology fellowship at Lurie Children’s Hospital in Chicago followed by a pediatric critical care fellowship at Morgan Stanley Children’s Hospital at Columbia University School of Medicine. His areas of interest are the impact of clinical simulation to improve team performance, clinical outcomes of PCICU patients and clinical outcomes of patients on mechanical circulatory support in the PCICU.

Dr. Gav Apfel is a CICU hospitalist at Columbia University College of Physicians and Surgeons. He completed his residency training at Columbia University College of Physicians and Surgeons and will be joining the Columbia University’s critical care fellowship program next year. He is interested in pursuing a career in cardiac intensive care.

Objectives
By the end of this podcast series, listeners should be able to:

Strategize how to approach an arrest as the code leader
Recognize the key elements of high-quality CPR and how to optimize perfusion during an arrest
Recall airway management, oxygenation, and ventilation during CPR
Recall different approaches to physiological monitoring during an arrest to guide therapy
Recognize appropriate resuscitation drug administration and timing during CPR
Recall management with manual defibrillation for arrests with a shockable rhythm
Develop approach to determining code duration and when to discontinue CPR

How to support PedsCrit
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

James D. Fortenberry MD, MCCM, FAAP is a Professor Pediatrics in the Division of Pediatric Critical Care at Emory University School of Medicine. He is the Chief Medical Officer of Children's Healthcare of Atlanta & the interim Chief of Critical Care Medicine. He is a past Chair of Critical Care sub-board of the American Board of Pediatrics and on SCCM and AAP critical care committees He is also a past president of Extracorporeal Life Support Organization (ELSO).

Objective:By the end of this podcast, listeners should be able to identify key leadership skills across the spectrum of an academic career and apply these to their own professional development.

How to support PedsCrit
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Nada Mallick is a pediatric intensivist at Children's National Hospital in Washington, DC. She has a master’s in Biochemistry and Molecular Biology from the Johns Hopkins University School of Public Health, after which she did her medical residency and chief resident year at Virginia Commonwealth University and her critical care fellowship at Children's National Hospital. Nada now serves as the physician chair for both the Pediatric Early Recognition and Resuscitation Committee and the Late Rescue Collaborative at Children’s National.

Learning Objectives:
By the end of this series, listeners should be able to:
1) Describe techniques for diagnosis of historically oppressed groups
2) Describe acute stabilization of impending hypoxemic respiratory failure from a complicated pneumonia.
3) Discuss workup for a patient with undifferentiated shock.
4) Describe options for ICU support for a patient who does not meet ICU criteria.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

View Details

Dr. Nada Mallick is a pediatric intensivist at Children's National Hospital in Washington, DC. She has a master’s in Biochemistry and Molecular Biology from the Johns Hopkins University School of Public Health, after which she did her medical residency and chief resident year at Virginia Commonwealth University and her critical care fellowship at Children's National Hospital. Nada now serves as the physician chair for both the Pediatric Early Recognition and Resuscitation Committee and the Late Rescue Collaborative at Children’s National.

Learning Objectives:
By the end of this series, listeners should be able to:
1) Describe techniques for diagnosis of historically oppressed groups
2) Describe acute stabilization of impending hypoxemic respiratory failure from a complicated pneumonia.
3) Discuss workup for a patient with undifferentiated shock.
4) Describe options for ICU support for a patient who does not meet ICU criteria.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Priya Bhaskar, M.D. is an Associate Professor of Pediatrics at UT Southwestern and an attending in the Cardiac ICU at Children’s Medical Center Dallas. She completed her pediatric residency at Inova Children’s Hospital in Virginia and critical care fellowship at UTSW prior to completing a 1 year CICU fellowship at Laurie Children’s in Chicago. Prior to her current position here at UTSW she was a cardiac intensivist at Arkansas Children’s Hospital. Her professional interests include extracorporeal support and education. She serves on the ECMO team as a core staff physician, and she has co-authored a review on this topic that we will use to guide our conversation.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The general indications for VA-ECMO in pediatrics.
The anatomic and physiologic rationale supporting various VA-ECMO cannulation strategies.
Physiologic targets to ensure adequate oxygen delivery for patients on VA-ECMO.
Hemodynamic complications of VA-ECMO such as left atrial hypertension and harlequin syndrome and general strategies in their management.
Liberation strategies for VA-ECMO either to decannulation or conversion to ventricular assist device.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

References:

Bhaskar, P., Davila, S., Hoskote, A., & Thiagarajan, R. (2021). Use of ECMO for Cardiogenic Shock in Pediatric Population. Journal of clinical medicine, 10(8), 1573. https://doi.org/10.3390/jcm10081573

Brown G, Moynihan KM, Deatrick KB, Hoskote A, Sandhu HS, Aganga D, Deshpande SR, Menon AP, Rozen T, Raman L, Alexander PMA. Extracorporeal Life Support Organization (ELSO): Guidelines for Pediatric Cardiac Failu

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Michelle Kittleson is the Director of Postgraduate Education in Heart Failure and Transplantation, Director of Heart Failure Research, and Professor of Medicine at the Smidt Heart Institute at Cedars-Sinai. She received her MD at Yale University School of Medicine followed by a residency in Internal Medicine at Brigham and Women's Hospital, and a fellowship in Cardiology at John Hopkins, where she also received a PhD in clinical investigation from the Johns Hopkins Bloomberg School of Public Health.

Dr. Kittleson is also a guideline author: she was the chair of the writing group for the 2020 American Heart Association Scientific Statement on Cardiac Amyloidosis; she also co-authored the American College of Cardiology’s 2020 Hypertrophic Cardiomyopathy Guidelines and the American Heart Association’s 2022 Heart Failure Guidelines.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Describe goals for rounds on a busy inpatient service.
Critique the common methods for priming trainees for optimal rounds.
Develop a technique for working with trainees at different levels of patient ownership, including the toddler, the waiter, and the captain.
Discuss the best times to add teaching points on rounds
Discuss the different ways to structure feedback on a busy inpatient team.

Dr. Kittleson's Textbook on patient care:

Mastering the Art of Patient Care 1st Edition. 2022. (Amazon Link)

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Proshad Efune, MD is an Assistant Professor at UT Southwestern. She completed both her pediatric critical care and pediatric anesthesia fellowships here at UT, and she now practices in both the operating room and the pediatric ICU here at Children’s Medical Center in Dallas. She is interested in pre-operative management of critically ill children. Learning Objectives
After listening to this episode, learners should be able to:

Identify clinical scenarios at high risk for cardiovascular collapse surrounding endotracheal intubation.
Discuss a clinical approach to minimize the risk of peri-intubation cardiovascular collapse in the following high-risk scenarios:
1. Severe hypoxemia
2. Severe metabolic acidosis
3. Hypotension/septic shock
4. Obstructive lung disease
5. Hemorrhagic shock
6. Cardiac tamponade

How to support PedsCrit
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Dr. Eric Silver is an Associate Professor of pediatrics at Columbia University Medical Center. He completed his cardiology fellowship at Columbia University College of Physicians and Surgeons and his electrophysiology fellowship at Stanford’s Lucile Packard Children’s Hospital. He is a certified specialist in pediatric electrophysiology and his research has focused on invasive management of AV nodal reentrant tachycardia in children, the response of the transplanted heart to adenosine therapy, and placement of pacemakers and ICDs with minimal fluoroscopy utilizing 3-dimensional mapping systems.

Gav Apfel is a CICU hospitalist at Columbia University College of Physicians and Surgeons. He completed his residency training at Columbia University College of Physicians and Surgeons and will be joining the Columbia University’s critical care fellowship program next year. He is interested in pursuing a career in cardiac intensive care.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Recognize common indications for temporary pacing in the CICU
Understand the nomenclature used to describe temporary epicardial pacemakers and different pacing modalities
Recall the function of each pacing mode and which clinical settings in which it is used
Recognize the surgical and pre surgical factors that lead to higher risk of arrhythmias
Recognize and troubleshoot temporary pacemaker dysfunction
Develop a mental framework for managing those who require prolonged pacing

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please complete our Listener Feedback Survey

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

References:

Pediatr

Support the Show.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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About our Guest:

Bradley Fuhrman, MD completed his training in pediatrics followed by fellowships in cardiology and neonatology at the University of Minnesota where he went on to found the first PICU and serve as the Chief of critical care at that institution. He has also served as the associate director of the PICU at Children’s Hospital of Pittsburgh, Division Chief of Critical Care at Children’s Hospital Buffalo and Physician-in-Chief at El Paso Children’s Hospital. His career in pediatric critical care exceeds 40 years. He has many peer-reviewed publications with a research career that is focused in cardiac and respiratory physiology. He is also the co-author of Fuhrman and Zimmerman’s Pediatric Critical Care.

Learning Objectives:

By the end of listening to this 2-part series, learners should be able to discuss clinically relevant cardiopulmonary interactions and a fundamental clinical approach to optimizing cardiopulmonary mechanics in patients with:

Spontaneous (negative pressure) respirations with severe work of breathing
Septic shock
Mechanical (positive pressure) ventilation
Pulmonary hypertension with right ventricular systolic dysfunction
Left ventricular systolic dysfunction
Right ventricular diastolic dysfunction
Single ventricle Fontan circulation

References:

Bronicki RA, Penny DJ, Anas NG, Fuhrman B. Cardiopulmonary Interactions. Pediatr Crit Care Med. 2016 Aug;17(8 Suppl 1):S182-93. doi: 10.1097/PCC.0000000000000829. PMID: 27490598.

Fuhrman and Zimmerman's Pediatric Critical Care 6th EditionHow to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please complete our Listener Feedback Survey (<5 min).

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

Fuhrman and Zimmerman's Pediatric Critical Care

View Details

About our Guest:

Bradley Fuhrman, MD completed his training in pediatrics followed by fellowships in cardiology and neonatology at the University of Minnesota where he went on to found the first PICU and serve as the Chief of critical care at that institution. He has also served as the associate director of the PICU at Children’s Hospital of Pittsburgh, Division Chief of Critical Care at Children’s Hospital Buffalo and Physician-in-Chief at El Paso Children’s Hospital. His career in pediatric critical care exceeds 40 years. He has many peer-reviewed publications with a research career that is focused in cardiac and respiratory physiology. He is also the co-author of Fuhrman and Zimmerman’s Pediatric Critical Care.

Learning Objectives:

By the end of listening to this 2-part series, learners should be able to discuss clinically relevant cardiopulmonary interactions and a fundamental clinical approach to optimizing cardiopulmonary mechanics in patients with:

Spontaneous (negative pressure) respirations with severe work of breathing
Septic shock
Mechanical (positive pressure) ventilation
Pulmonary hypertension with right ventricular systolic dysfunction
Left ventricular systolic dysfunction
Right ventricular diastolic dysfunction
Single ventricle Fontan circulation

References:

Bronicki RA, Penny DJ, Anas NG, Fuhrman B. Cardiopulmonary Interactions. Pediatr Crit Care Med. 2016 Aug;17(8 Suppl 1):S182-93. doi: 10.1097/PCC.0000000000000829. PMID: 27490598.

Fuhrman and Zimmerman's Pediatric Critical Care 6th EditionHow to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please complete our Listener Feedback Survey (<5 min).

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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About our Guest:

Jerry Zimmerman, M.D, PhD, FCCM is a Professor of Pediatrics at the University of Washington and the former Chief of the Division of Critical Care Medicine and the Director of the Pediatric Intensive Care Unit at Seattle Children’s Hospital. He is a past president of the Society of Critical Care Medicine. Dr. Zimmerman is the co-editor of the textbook Pediatric Critical Care and is an accomplished researcher. He was a charter principal investigator in the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network and is a co-principal investigator for the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) trial that we will discuss later in this episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting and opposing the use of corticosteroids in septic shock.
The high-quality clinical evidence supporting and opposing the use of corticosteroids in septic shock.
The current practice patterns among pediatric intensivists in prescribing corticosteroids in septic shock.
The clinically relevant side effects associated with corticosteroids in septic shock.
Future research of corticosteroids in septic shock with emphasis on the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) study.

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Key reference:

Zimmerman, Jerry J. MD, PhD, FCCM. A history of adjunctive glucocorticoid treatment for pediatric sepsis: Moving beyond steroid pulp fiction toward evidence-based medicine. Pediatric Critical Care Medicine: November 2007 - Volume 8 - Issue 6 - p 530-539

Other references:

PMID: 32058370
PMID: 20228689
PMID: 29979221
PMID: 29490185
PMID: 29347874
PMID: 27695824
PMID: 18184957
PMID: 12186604

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View Details

About our Guest:

Jerry Zimmerman, M.D, PhD, FCCM is a Professor of Pediatrics at the University of Washington and the former Chief of the Division of Critical Care Medicine and the Director of the Pediatric Intensive Care Unit at Seattle Children’s Hospital. He is a past president of the Society of Critical Care Medicine. Dr. Zimmerman is the co-editor of the textbook Pediatric Critical Care and is an accomplished researcher. He was a charter principal investigator in the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network and is a co-principal investigator for the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) trial that we will discuss later in this episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting and opposing the use of corticosteroids in septic shock.
The high-quality clinical evidence supporting and opposing the use of corticosteroids in septic shock.
The current practice patterns among pediatric intensivists in prescribing corticosteroids in septic shock.
The clinically relevant side effects associated with corticosteroids in septic shock.
Future research of corticosteroids in septic shock with emphasis on the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) study.

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Key reference:

Zimmerman, Jerry J. MD, PhD, FCCM. A history of adjunctive glucocorticoid treatment for pediatric sepsis: Moving beyond steroid pulp fiction toward evidence-based medicine. Pediatric Critical Care Medicine: November 2007 - Volume 8 - Issue 6 - p 530-539

Other references:

PMID: 32058370
PMID: 20228689
PMID: 29979221
PMID: 29490185
PMID: 29347874
PMID: 27695824
PMID: 18184957
PMID: 12186604

Support the show

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About our Guests:

Dr. Warren Zuckerman is an associate professor of pediatrics as well as the associate director of the pediatric cardiology division at the Columbia University College of Physicians and Surgeons in New York. He completed both his pediatric residency and his cardiology fellowship at Columbia University College of Physicians and Surgeons. He is now a practicing pediatric cardiologist at Morgan Stanley Children’s Hospital. His research interests include pediatric cardiomyopathies, donor- and recipient-related issues surrounding pediatric heart transplantation, and drug therapies for prevention and treatment of graft rejection following heart transplantation.

Gav Apfel is a CICU hospitalist at Columbia University College of Physicians and Surgeons. He completed his residency training at Columbia University College of Physicians and Surgeons and will be joining the Columbia University’s critical care fellowship program in July 2023. He is interested in pursuing a career in cardiac intensive care.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Describe the common indications for pediatric heart transplant.
Recall the goals of preoperative management of heart failure patients and medical optimization for heart transplant.
Recall the general surgical strategies for cardiac implantation.
Recognize the key information provided in surgical and anesthesia handover that will affect postoperative management.
Recognize the common and important postoperative complications and develop an approach to their management.
Develop a mental framework of the expected postoperative CICU course with a focus on common or important barriers to ICU discharge.
Recall important long-term complications of heart transplant with an emphasis on those that might result in critical illness.

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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About our Guests:

Dr. Warren Zuckerman is an associate professor of pediatrics as well as the associate director of the pediatric cardiology division at the Columbia University College of Physicians and Surgeons in New York. He completed both his pediatric residency and his cardiology fellowship at Columbia University College of Physicians and Surgeons. He is now a practicing pediatric cardiologist at Morgan Stanley Children’s Hospital. His research interests include pediatric cardiomyopathies, donor- and recipient-related issues surrounding pediatric heart transplantation, and drug therapies for prevention and treatment of graft rejection following heart transplantation.

Gav Apfel is a CICU hospitalist at Columbia University College of Physicians and Surgeons. He completed his residency training at Columbia University College of Physicians and Surgeons and will be joining the Columbia University’s critical care fellowship program in July 2023. He is interested in pursuing a career in cardiac intensive care.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Describe the common indications for pediatric heart transplant.
Recall the goals of preoperative management of heart failure patients and medical optimization for heart transplant.
Recall the general surgical strategies for cardiac implantation.
Recognize the key information provided in surgical and anesthesia handover that will affect postoperative management.
Recognize the common and important postoperative complications and develop an approach to their management.
Develop a mental framework of the expected postoperative CICU course with a focus on common or important barriers to ICU discharge.
Recall important long-term complications of heart transplant with an emphasis on those that might result in critical illness.

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Megan & Ross Maenius are parents to Mila and patient advocates at Children's Medical Center Dallas. They have an incredible story to tell about their child's journey that may help the next time you are caring for a patient with chronic medical complexity in the pediatric ICU.

Erin Gordon, D.O. is an Associate Professor of Pediatrics at University of Texas Southwestern and an intensivist in the pediatric cardiac intensive care unit. Dr. Gordon is the medical director of the inpatient developmental care program and directly involved in creating an environment that fosters the growth and development of the congenital heart disease population, including parental mental health and resilience. Her passion for patient and family advocacy has led to her desire to bring a louder voice to the concept of a “primary” intensivist.

Learning objectives:

After listening to this episode, learners should be able to:

Recognize the parental consequences of children with complex chronic conditions and those requiring a prolonged ICU stay.
Recognize aspects of ICU care that limit effective communication between parents/caregivers and clinicians.
Discuss strategies to improve communication between parents/caregivers and clinicians including the role of a primary intensivist program.
Discuss ways that parents/caregivers and clinicians can partner together to improve the care provided to children in the ICU.

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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About our guests:

Jeffrey Edwards, M.D is an Associate Professor of Pediatrics at Columbia University and a pediatric intensivist at Morgan Stanley Children’s Hospital in New York. He is an active physician-investigator with clinical and research interests in children with complex chronic conditions and technology-dependence.

Erin Gordon, D.O. is an Assistant Professor of Pediatrics at University of Texas Southwestern and an intensivist in the pediatric cardiac intensive care unit. Dr. Gordon is the medical director of the inpatient developmental care program and directly involved in creating an environment that fosters the growth and development of the congenital heart disease population, including parental mental health and resilience. Her passion for patient and family advocacy has led to her desire to bring a louder voice to the concept of a “primary” intensivist.

Learning objectives:

After listening to this series of episodes, learners should be able to discuss:

The discrepant health-related outcomes of long-stay patients (LSP) and those with complex chronic conditions (CCC) in the PICU.
Barriers to delivering effective care to LSPs and those with CCC in the PICU.
Strategies to improve continuity of care to LSPs and to those with CCC in the PICU.
The rationale and evidence supporting the use of a primary intensivist program in the PICU.
Patient eligibility criteria and best practices of a primary intensivist program with an emphasis on equity and minimizing the risk of bias.
Physician specific and healthcare system related strategies to maintaining a successful primary intensivist program.
The role of a PICU fellow in providing care similar to a primary intensivist.
Next steps in implementation and research of primary intensivists in PICUs.

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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About our guests:

Jeffrey Edwards, M.D is an Associate Professor of Pediatrics at Columbia University and a pediatric intensivist at Morgan Stanley Children’s Hospital in New York. He is an active physician-investigator with clinical and research interests in children with complex chronic conditions and technology-dependence.

Erin Gordon, D.O. is an Assistant Professor of Pediatrics at University of Texas Southwestern and an intensivist in the pediatric cardiac intensive care unit. Dr. Gordon is the medical director of the inpatient developmental care program and directly involved in creating an environment that fosters the growth and development of the congenital heart disease population, including parental mental health and resilience. Her passion for patient and family advocacy has led to her desire to bring a louder voice to the concept of a “primary” intensivist.

Learning objectives:

After listening to this series of episodes, learners should be able to discuss:

The discrepant health-related outcomes of long-stay patients (LSP) and those with complex chronic conditions (CCC) in the PICU.
Barriers to delivering effective care to LSPs and those with CCC in the PICU.
Strategies to improve continuity of care to LSPs and to those with CCC in the PICU.
The rationale and evidence supporting the use of a primary intensivist program in the PICU.
Patient eligibility criteria and best practices of a primary intensivist program with an emphasis on equity and minimizing the risk of bias.
Physician specific and healthcare system related strategies to maintaining a successful primary intensivist program.
The role of a PICU fellow in providing care similar to a primary intensivist.
Next steps in implementation and research of primary intensivists in PICUs.

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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Dr. Yurasek is a graduate of the Columbia University College of Physicians and Surgeons. He completed his pediatric residency at Children’s Hospital of Boston followed by a pediatric cardiology fellowship also at Boston Children’s and a PICU fellowship at Massachusetts General Hospital. He is now a CICU attending and the director of critical care simulation at Children’s National Hospital in Washington, DC.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:1. Understand the physiologic considerations that influence preoperative care in the cardiac intensive care unit (CICU).
2. Recall the goals and general steps of operative repair.
3. Recognize the key information provided in post-op handoff that will affect management.
4. Recognize important postoperative complications and develop an approach to their management.
5. Develop a mental framework of the expected postoperative CICU course with a focus on barriers to ICU discharge.

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Dr. Yurasek is a graduate of the Columbia University College of Physicians and Surgeons. He completed his pediatric residency at Children’s Hospital of Boston followed by a pediatric cardiology fellowship also at Boston Children’s and a PICU fellowship at Massachusetts General Hospital. He is now a CICU attending and the director of critical care simulation at Children’s National Hospital in Washington, DC.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:1. Understand the physiologic considerations that influence preoperative care in the cardiac intensive care unit (CICU).
2. Recall the goals and general steps of operative repair.
3. Recognize the key information provided in post-op handoff that will affect management.
4. Recognize important postoperative complications and develop an approach to their management.
5. Develop a mental framework of the expected postoperative CICU course with a focus on barriers to ICU discharge.
Support the show

Support the show

View Details

Dr. Yurasek is a graduate of the Columbia University College of Physicians and Surgeons. He completed his pediatric residency at Children’s Hospital of Boston followed by a pediatric cardiology fellowship also at Boston Children’s and a PICU fellowship at Massachusetts General Hospital. He is now a CICU attending and the director of critical care simulation at Children’s National Hospital in Washington, DC.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:1. Understand the physiologic considerations that influence preoperative care in the cardiac intensive care unit (CICU).
2. Recall the goals and general steps of operative repair.
3. Recognize the key information provided in post-op handoff that will affect management.
4. Recognize important postoperative complications and develop an approach to their management.
5. Develop a mental framework of the expected postoperative CICU course with a focus on barriers to ICU discharge.

Support the show

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Listener Feedback Survey

Learning Objectives:After listening to this episode, learners should be able to:

Explain the key milestones that a patient needs to reach before they are a candidate for extubation while on VV-ECMO.
Contrast the mobilization best practices for infants vs school-aged children on VV-ECMO.
Describe the long-term neurologic effects of a VV-ECMO run, both in infancy and as a school-aged child.

About our guests:

Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

Dr John Daniel, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. He completed his pediatric residency at the University of South Carolina and his neonatology fellowship at the University of Kentucky. He now is a practicing Neonatal Cardiac Intensivist and the director of the neonatal ECMO program at Children’s Mercy Kansas City.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covid

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition.
Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.
Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation.
Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation.
Gurnani et al. Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation,
Kohne et al. Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation
Palen P et al. tracheostomy and long-term mechanical ventilation in children after veno-venous extracorporeal membrane oxygenation.
LaRosa JM, Nelliot A, Zaidi M, Vaidya D, Awojoodu R, Kudchadkar SR. Mobilization Safety of Critically Ill Children. Pediatrics.

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Listener Feedback Survey

Learning Objectives:After listening to this episode, learners should be able to:

Discuss common issues with the VV-ECMO circuit and describe how to troubleshoot them.
Describe a general approach for providing nutrition to patients on VV-ECMO.
Identify key ways to move a patient on VV-ECMO towards early extubation and mobilization.

About our guests:

Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

Dr John Daniel, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. He completed his pediatric residency at the University of South Carolina and his neonatology fellowship at the University of Kentucky. He now is a practicing Neonatal Cardiac Intensivist and the director of the neonatal ECMO program at Children’s Mercy Kansas City.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covid

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition.
Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.
Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation.
Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation.
Gurnani et al. Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation,
Kohne et al. Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation
Palen P et al. tracheostomy and long-term mechanical ventilation in children after veno-venous extracorporeal membrane oxygenation.
LaRosa JM, Nelliot A, Zaidi M, Vaidya D, Awojoodu R, Kudchadkar SR. Mobilization Safety of Critically Ill Children. Pediatrics.

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Listener Feedback Survey

Learning Objectives:After listening to this episode, learners should be able to:

Critique the different VV-ECMO canula configurations available for neonates and children.
Describe common strategies for monitoring canula placement in neonates and children.
Discuss the two main thought processes for ventilation strategy during VV-ECMO in neonates and children.

About our guests:

Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

Dr John Daniel, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. He completed his pediatric residency at the University of South Carolina and his neonatology fellowship at the University of Kentucky. He now is a practicing Neonatal Cardiac Intensivist and the director of the neonatal ECMO program at Children’s Mercy Kansas City.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covid

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition.
Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.
Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation.
Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation.
Gurnani et al. Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation,
Kohne et al. Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation
Palen P et al. tracheostomy and long-term mechanical ventilation in children after veno-venous extracorporeal membrane oxygenation.
LaRosa JM, Nelliot A, Zaidi M, Vaidya D, Awojoodu R, Kudchadkar SR. Mobilization Safety of Critically Ill Children. Pediatrics.

Support the show

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Listener Feedback Survey

Learning Objectives:

After listening to this episode, learners should be able to:

The Identify key networking opportunities within the ECMO world.
Understand the risks and benefits of VV-ECMO cannulation.
Discuss common and newer indications for VV-ECMO cannulation in neonates and school-aged children.

About our guests:

Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

Dr John Daniel, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. He completed his pediatric residency at the University of South Carolina and his neonatology fellowship at the University of Kentucky. He now is a practicing Neonatal Cardiac Intensivist and the director of the neonatal ECMO program at Children’s Mercy Kansas City.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covid

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition.
Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.
Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation.
Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation.
Gurnani et al. Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation,
Kohne et al. Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation
Palen P et al. tracheostomy and long-term mechanical ventilation in children after veno-venous extracorporeal membrane oxygenation.
LaRosa JM, Nelliot A, Zaidi M, Vaidya D, Awojoodu R, Kudchadkar SR. Mobilization Safety of Critically Ill Children. Pediatrics.

Support the show

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Listener Feedback Survey

About our Guest:

Scott Weiss, MD is an Associate Professor of Pediatrics and Pathology at Thomas Jefferson University. He serves as the Chair of the Division of Pediatric Critical Care Medicine at Nemours Children’s Hospital in Wilmington, Delaware. Dr. Weiss’ research focuses on epidemiology of pediatric sepsis and mitochondrial dysfunction in sepsis-associated organ injury. He recently served as the Co-Vice Chair for the international Pediatric Surviving Sepsis Campaign and was first author on the 2020 pediatric sepsis guidelines.

Learning Objectives:

By the end of this podcast series, listeners should be able to:

Describe the high-quality literature of fluid boluses in the management of pediatric septic shock.
Recognize how healthcare settings and resource availability may affect the utility of fluid boluses in select pediatric patients with suspected septic shock.
Recall the limitation of the beside assessment to determine if a patient with sepsis is suffering from “cold” or “warm” shock.
Describe the role of advanced hemodynamic monitoring in determining a patient's underlying physiology in septic shock.
Describe an approach to choosing initial and second-line vasoactive medications in septic shock.
Describe the physiologic rationale, evidence, and limitations of targeting a higher hemoglobin threshold for patients with ongoing septic shock.
Describe the physiologic rationale, evidence, and limitations of using a combination of hydrocortisone, ascorbic acid, and thiamine (HAT) in the management of septic shock.
Recognize when VA-ECMO might be indicated in pediatric septic shock.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Reference:Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, Nadel S, Schlapbach LJ, Tasker RC, Argent AC, Brierley J, Carcillo J, Carrol ED, Carroll CL, Cheifetz IM, Choong K, Cies JJ, Cruz AT, De Luca D, Deep A, Faust SN, De Oliveira CF, Hall MW, Ishimine P, Javouhey E, Joosten KFM, Joshi P, Karam O, Kneyber MCJ, Lemson J, MacLaren G, Mehta NM, Møller MH, Newth CJL, Nguyen TC, Nishisaki A, Nunnally ME, Parker MM, Paul RM, Randolph AG, Ranjit S, Romer LH, Scott HF, Tume LN, Verger JT, Williams EA, Wolf J, Wong HR, Zimmerman JJ, Kissoon N, Tissieres P. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med. 2020 Feb;21(2):e52-e106. doi: 10.1097/PCC.0000000000002198. PMID: 32032273.

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About our Guest:

Scott Weiss, MD is an Associate Professor of Pediatrics and Pathology at Thomas Jefferson University. He serves as the Chair of the Division of Pediatric Critical Care Medicine at Nemours Children’s Hospital in Wilmington, Delaware. Dr. Weiss’ research focuses on epidemiology of pediatric sepsis and mitochondrial dysfunction in sepsis-associated organ injury. He recently served as the Co-Vice Chair for the international Pediatric Surviving Sepsis Campaign and was first author on the 2020 pediatric sepsis guidelines.

Learning Objectives:

By the end of this podcast series, listeners should be able to:

Describe the high-quality literature of fluid boluses in the management of pediatric septic shock.
Recognize how healthcare settings and resource availability may affect the utility of fluid boluses in select pediatric patients with suspected septic shock.
Recall the limitation of the beside assessment to determine if a patient with sepsis is suffering from “cold” or “warm” shock.
Describe the role of advanced hemodynamic monitoring in determining a patient's underlying physiology in septic shock.
Describe an approach to choosing initial and second-line vasoactive medications in septic shock.
Describe the physiologic rationale, evidence, and limitations of targeting a higher hemoglobin threshold for patients with ongoing septic shock.
Describe the physiologic rationale, evidence, and limitations of using a combination of hydrocortisone, ascorbic acid, and thiamine (HAT) in the management of septic shock.
Recognize when VA-ECMO might be indicated in pediatric septic shock.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Reference:Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, Nadel S, Schlapbach LJ, Tasker RC, Argent AC, Brierley J, Carcillo J, Carrol ED, Carroll CL, Cheifetz IM, Choong K, Cies JJ, Cruz AT, De Luca D, Deep A, Faust SN, De Oliveira CF, Hall MW, Ishimine P, Javouhey E, Joosten KFM, Joshi P, Karam O, Kneyber MCJ, Lemson J, MacLaren G, Mehta NM, Møller MH, Newth CJL, Nguyen TC, Nishisaki A, Nunnally ME, Parker MM, Paul RM, Randolph AG, Ranjit S, Romer LH, Scott HF, Tume LN, Verger JT, Williams EA, Wolf J, Wong HR, Zimmerman JJ, Kissoon N, Tissieres P. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med. 2020 Feb;21(2):e52-e106. doi: 10.1097/PCC.0000000000002198. PMID: 32032273.

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About our Guest:

Samuel Davila, M.D. is an Associate Professor of Pediatrics here at UT Southwestern. He completed both his pediatric infectious disease and critical care fellowships at Washington University at St. Louis Children’s Hospital. He now is a practicing pediatric infectious disease specialist and intensivist at the UTSW/ Children’s Medical Center in Dallas, Texas. His professional and research interests include cardiovascular infections, cardiac ECMO, and post heart transplant infections. I spend time doing handshake stewardship in the ICUs and committee work for hospital acquired conditions and infection prevention.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define ventilator-associated conditions and infection-related ventilator-associated complications (IVAC).
Recall the clinical characteristics and laboratory tests required to diagnose ventilator-associated pneumonia (VAP).
Differentiate VAP from tracheitis.
Recall the common or worrisome pathogens associated with VAP.
Recall principles guiding empiric antibiotic selection for a patient with suspected VAP.
Recognize the importance of antimicrobial stewardship in management of VAP and develop a strategy to limit unnecessary antibiotics (duration of therapy, strategies for narrowing coverage or discontinuing antibiotics if other diagnosis is more likely).
Recognize when consultation with infectious disease is recommended in the management of VAP.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

References:

Willson DF, Hoot M, Khemani R, Carrol C, Kirby A, Schwarz A, Gedeit R, Nett ST, Erickson S, Flori H, Hays S, Hall M; Ventilator-Associated INfection (VAIN) Investigators and the Pediatric Acute Lung Injury and Sepsis Investigator’s (PALISI) Network. Pediatric Ventilator-Associated Infections: The Ventilator-Associated INfection Study. Pediatr Crit Care Med. 2017 Jan;18(1):e24-e34. doi: 10.1097/PCC.0000000000001001. PMID: 27828898.
Spalding MC, Cripps MW, Minshall CT. Ventilator-Associated Pneumonia: New Definitions. Crit Care Clin. 2017 Apr;33(2):277-292. doi: 10.1016/j.ccc.2016.12.009. Epub 2017 Jan 18. PMID: 28284295; PMCID: PMC7127414.

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About our guest:

Karen Fauman, MD is an Associate Professor of Pediatrics at the University of Chicago and dual boarded pediatric intensivist and palliative care physician at Comer Children’s. She received her medical degree, pediatric and pediatric critical care training at the University of Michigan. Now at the University of Chicago she serves as the critical care medicine fellowship program director and the ECMO medical director. She is very active in ECMO-related research with an added focus on the psychosocial aspects of critical care in children.

The Cribsiders:

The Cribsiders is a pediatric medicine podcast composed of a national network of students, residents and clinician educators from across the country and multiple institutions. On the show we “curbside” the experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge and a weight-based dosing of fun.

Learning Objectives:

After listening to this episode listeners will…

Recall the basic pathophysiology of oxygen delivery
Identify the different indications for VV and VA ECMO
Be familiar with the basic sequence of the ECMO circuit
Recognize ECMO settings and how changing these will impact oxygenation and ventilation
Be familiar with signs that a patient may be ready to be liberated from ECMO

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

View Details

About our guest:

Karen Fauman, MD is an Associate Professor of Pediatrics at the University of Chicago and dual boarded pediatric intensivist and palliative care physician at Comer Children’s. She received her medical degree, pediatric and pediatric critical care training at the University of Michigan. Now at the University of Chicago she serves as the critical care medicine fellowship program director and the ECMO medical director. She is very active in ECMO-related research with an added focus on the psychosocial aspects of critical care in children.

The Cribsiders:

The Cribsiders is a pediatric medicine podcast composed of a national network of students, residents and clinician educators from across the country and multiple institutions. On the show we “curbside” the experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge and a weight-based dosing of fun.

Learning Objectives:

After listening to this episode listeners will…

Recall the basic pathophysiology of oxygen delivery
Identify the different indications for VV and VA ECMO
Be familiar with the basic sequence of the ECMO circuit
Recognize ECMO settings and how changing these will impact oxygenation and ventilation
Be familiar with signs that a patient may be ready to be liberated from ECMO

How to support PedsCrit:

Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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Listener Feedback Survey
About our guest:
Dr. Whyte-Nesfield is a Critical Care attending at Children’s National Hospital in Washington, DC. She completed her medical degree in her home country of Grenada at St. George’s University, and her fellowship in Pediatric Critical Care at Penn State Health Children’s Hospital, PA. Mekela’s research interest is the role of parent and child traumatic stress management in improving long term outcomes of children in the PICU; she ran a multi-center prevalence study during her fellowship. She is also interested in advanced ventilator modes and educating the next generation of intensivists about pulmonary physiology.

Objectives:
After listening to this episode, listeners should be able to:

Define indications for intubation in a patient with asthma.
Review adjunct therapies, including high-dose steroids, mag, epi, terbutaline, isoproterenol, aminophylline, isoflurane, and manual decompression of the chest.
Identify the physiologic and logistic rationale supporting each mode of mechanical ventilation in asthma (PRVC vs PCPS).
Identify the benefits and risks of paralyzing an intubated asthmatic.
Discuss the relationshiop between static compliance, dynamic compliance, and reversible bronchoconstriction.
Describe the complications of mechanical ventilation in asthma, including indications for ECMO.

References:

Manual external chest compression reverses respiratory failure in children with severe air trapping. Pediatric Pulmonology, 56(12), 3887–3890. https://doi.org/10.1002/ppul.25689
Mechanical ventilation of the intubated asthmatic: How much do we really know? *. Pediatric Critical Care Medicine, 5(2), 191–192. https://doi.org/10.1097/01.CCM.0000113929.14813.51
Volatile Anesthetic Rescue Therapy in Children With Acute Asthma. Pediatric Critical Care Medicine, 14(4), 343–350. https://doi.org/10.1097/PCC.0b013e3182772e29
Pressure-controlled ventilation in children with severe status asthmaticus*. Pediatric Critical Care Medicine, 5(2), 133–138. https://doi.org/10.1097/01.PCC.0000112374.68746.E8
Endotracheal intubation and pediatric status asthmaticus: Site of original care affects treatment*. Pediatric Critical Care Medicine, 8(2), 91–95. https://doi.org/10.1097/01.PCC.0000257115.02573.FC

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

View Details

Listener Feedback Survey
About our guest:
Dr. Whyte-Nesfield is a Critical Care attending at Children’s National Hospital in Washington, DC. She completed her medical degree in her home country of Grenada at St. George’s University, and her fellowship in Pediatric Critical Care at Penn State Health Children’s Hospital, PA. Mekela’s research interest is the role of parent and child traumatic stress management in improving long term outcomes of children in the PICU; she ran a multi-center prevalence study during her fellowship. She is also interested in advanced ventilator modes and educating the next generation of intensivists about pulmonary physiology.

Objectives:
After listening to this episode, listeners should be able to:

Define indications for intubation in a patient with asthma.
Review adjunct therapies, including high-dose steroids, mag, epi, terbutaline, isoproterenol, aminophylline, isoflurane, and manual decompression of the chest.
Identify the physiologic and logistic rationale supporting each mode of mechanical ventilation in asthma (PRVC vs PCPS).
Identify the benefits and risks of paralyzing an intubated asthmatic.
Discuss the relationshiop between static compliance, dynamic compliance, and reversible bronchoconstriction.
Describe the complications of mechanical ventilation in asthma, including indications for ECMO.

References:

Manual external chest compression reverses respiratory failure in children with severe air trapping. Pediatric Pulmonology, 56(12), 3887–3890. https://doi.org/10.1002/ppul.25689
Mechanical ventilation of the intubated asthmatic: How much do we really know? *. Pediatric Critical Care Medicine, 5(2), 191–192. https://doi.org/10.1097/01.CCM.0000113929.14813.51
Volatile Anesthetic Rescue Therapy in Children With Acute Asthma. Pediatric Critical Care Medicine, 14(4), 343–350. https://doi.org/10.1097/PCC.0b013e3182772e29
Pressure-controlled ventilation in children with severe status asthmaticus*. Pediatric Critical Care Medicine, 5(2), 133–138. https://doi.org/10.1097/01.PCC.0000112374.68746.E8
Endotracheal intubation and pediatric status asthmaticus: Site of original care affects treatment*. Pediatric Critical Care Medicine, 8(2), 91–95. https://doi.org/10.1097/01.PCC.0000257115.02573.FC

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

View Details

Listener Feedback Survey
About our Guest:Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

Objectives:

After listening to this episode, learners should be able to:
Describe the rationale supporting and “ideal” patient that may benefit from various adjunctive therapies for PARDS:

Corticosteroids
Neuromuscular blockade
Prone positioning
Inhaled nitric oxide
Surfactant

Acknowledgement:
Thank you to Dr. Nick Bartel for his help in creating learning objectives for this series.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Selected references:

PMID: 10793162
PMID: 25693014.
PMID: 15269312
PMID: 30361119
PMID: 17426195
PMID: 31112383
PMID: 25647235
PMID: 19001507
PMID: 32043986.
PMID: 15671432.

Support the show

View Details

Listener Feedback Survey
About our Guest:Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

Objectives:

After listening to this episode, learners should be able to
Describe the rationale supporting and “ideal” patient that may benefit from various forms of non-conventional ventilation:

Neurally adjusted ventilatory assist (NAVA)
High-frequency oscillatory ventilation (HFOV)
High-frequency percussive ventilation (HFPV)
High-frequency jet ventilation (HFJF)
Airway pressure release ventilation (APRV)

Acknowledgement:
Thank you to Dr. Nick Bartel for his help in creating learning objectives for this series.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Selected references:

PMID: 10793162
PMID: 25693014.
PMID: 15269312
PMID: 30361119
PMID: 17426195
PMID: 31112383
PMID: 25647235
PMID: 19001507
PMID: 32043986.
PMID: 15671432.

Support the show

View Details

Listener Feedback Survey
About our Guest:Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

Objectives:

After listening to this episode, learners should be able to:

Develop a mental model for titrating PEEP in PARDS with the acknowledgement of standardized ARDSnet PEEP-FiO2 tables. (High vs Low PEEP strategy? Is this applicable to children?)
Understand the relationship between peak inspiratory pressure and plateau pressure in managing patients with PARDS in pressure control modes of ventilation.
Develop a mental model for understanding various measures of respiratory support and understand their strengths, limitations, and value as markers of ventilator induced lung injury (peak inspiratory pressure, plateau pressure, driving pressure, mechanical power).
Recognize the potential benefits of measuring esophageal pressure as a surrogate of transpleural pressure to titrate respiratory support in PARDS.

Acknowledgement:
Thank you to Dr. Nick Bartel for his help in creating learning objectives for this series.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Selected references:

PMID: 10793162
PMID: 25693014.
PMID: 15269312
PMID: 30361119
PMID: 17426195
PMID: 31112383
PMID: 25647235
PMID: 19001507
PMID: 32043986.
PMID: 156714

Support the show

View Details

Listener Feedback Survey
About our Guest:Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

Objectives:

After listening to this episode, learners should be able to:

Understand the role of heated high-flow nasal cannula and non-invasive mechanical ventilation in the management of pediatric acute respiratory distress syndrome (PARDS).
Recognize the potential for patient self-inflicted lung injury in PARDS.
Recognize high-risk situations when non-invasive mechanical ventilation is relatively contraindicated in favor of intubation and mechanical ventilation.

Acknowledgement:
Thank you to Dr. Nick Bartel for his help in creating learning objectives for this series.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Selected references:

PMID: 10793162
PMID: 25693014.
PMID: 15269312
PMID: 30361119
PMID: 17426195
PMID: 31112383
PMID: 25647235
PMID: 19001507
PMID: 32043986.
PMID: 15671432.

Support the show

View Details

Listener Feedback Survey
About our guest:Melinda Cory, M.D., is an Assistant Professor in the Department of Pediatrics at UT Southwestern Medical Center. She earned her medical degree at UT Southwestern, where she also completed her residency in pediatrics. She gained advanced training through fellowships in pediatric cardiology and pediatric critical care medicine at Emory University School of Medicine.

Board certified in pediatrics, pediatric cardiology, and pediatric critical care, she attends in the cardiovascular intensive care unit at Children's Medical Center in Dallas, TX. She is also very active in medical education including serving as the associate program director for the pediatric cardiology fellowship program and helps lead the pediatric critical care simulation team.

Learning objectives:
After listening to this episode on atrioventricular septal defects, learners should be able to:

Recognize the relevant preoperative anatomy that influences operative plan and postoperative care in the cardiac intensive care unit (CICU).
Recall the goals and general options for operative repair.
Recognize the key information provided in surgical and anesthesia handover that will affect postoperative management.
Recognize the common and important postoperative complications and develop an approach to their management.
Develop a mental framework of the expected postoperative CICU course with a focus on common or important barriers to ICU discharge.

References:Atrioventricular Septal Defects. Peter Sassalos MD, Ming-Sing Si MD, Richard G. Ohye MD, Edward L. Bove MD and Jennifer C. Romano MD, MS. Critical Heart Disease in Infants and Children, 50, 606-614.e2

Peterson JK, Setty SP, Knight JH, Thomas AS, Moller JH, Kochilas LK. Postoperative and long-term outcomes in children with Trisomy 21 and single ventricle palliation. Congenit Heart Dis. 2019 Sep;14(5):854-863. doi: 10.1111/chd.12823. Epub 2019 Jul 22. PMID: 31332952; PMCID: PMC7329297.

How to support PedsCrit:
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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Listener Feedback Survey
The Tracheostomy Decision Part 2 with Dr. Parisa Kaviany and Dr. Maria Arroyo
Objectives:By the end of listening to this episode, learners should be able to:

Describe how we know when we're at our goal ventilator settings
Understand the process of following up with pulmonology and the home care company's respiratory therapist
Troubleshoot common home vent questions, including tube positioning
Identify key parent resources

About our guests:
Dr. Parisa Kaviany is a former Children’s National Resident, she completed her pediatric pulmonology fellowship at Johns Hopkins and we were lucky enough to get her back as a pulmonologist. Dr. Kaviany’s research interest is health disparities among children with asthma.

Dr. Maria Arroyo did her pulmonology fellowship at Children’s National in DC and stayed as an attending, she also works at The HSC Pediatric Center, a subacute care facility in Washington, DC. Dr. Arroyo is THE person you want your patients’ parents to meet when they’re making the tracheostomy decision.

Mentioned in this episode:
Family Reflections: a website about deciding about home ventilation
ATS Trach Education PDF: A pediatric tracheostomy education PDF from the American Thoracic Society
Lilly's little lungs: one family's story of going home with a preemie who needs a trach and vent, the account follows her through a successful LTR.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.
Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes, and visit @critpeds on Twitter and @pedscrit on Instagram for real time show updates.

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The Tracheostomy Conversation with Dr. Parisa Kaviany and Dr. Maria Arroyo
Objectives:By the end of listening to this episode, learners should be able to:

Describe the typical stakeholders involved in a tracheostomy decision.
Understand the caregiver, spatial, and technical requirements of living at home with a tracheostomy.
Describe the requirements that must be met prior to discharge to an acute care facility.
Differentiate the ventilator weans that must take place prior to discharge home vs prior to discharge to an acute care facility.

About our guests:
Dr. Parisa Kaviany is a former Children’s National Resident, she completed her pediatric pulmonology fellowship at Johns Hopkins and we were lucky enough to get her back as a pulmonologist. Dr. Kaviany’s research interest is health disparities among children with asthma.

Dr. Maria Arroyo did her pulmonology fellowship at Children’s National in DC and stayed as an attending, she also works at The HSC Pediatric Center, a subacute care facility in Washington, DC. Dr. Arroyo is THE person you want your patients’ parents to meet when they’re making the tracheostomy decision.

Mentioned in this episode:
Family Reflections: a website about deciding about home ventilation
ATS Trach Education PDF: A pediatric tracheostomy education PDF from the American Thoracic Society
Lilly's little lungs: one family's story of going home with a preemie who needs a trach and vent, the account follows her through a successful LTR.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes, and visit @critpeds on Twitter and @pedscrit on Instagram for real time show updates.

Support the show

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After listening to this episode on Tetralogy of Fallot with Pulmonary Stenosis, learners should be able to:

Recognize the relevant preoperative anatomy that influences operative plan and postoperative care in the cardiac intensive care unit (CICU).
Recall the goals and general steps of operative repair.
Recognize the key information provided in surgical and anesthesia handover that will affect postoperative management.
Recognize the common and important postoperative complications and develop an approach to their management.
Develop a mental framework of the expected postoperative CICU course with a focus on common or important barriers to ICU discharge.

About our guest:

Dr. Laura Ortmann is an Associate Professor in the Department of Pediatrics at the University of Nebraska College of Medicine. She serves as the Medical Director of the Cardiovascular Intensive Care Unit at Children’s Hospital and Medical Center in Omaha, Nebraska. She a CPR researcher and a great medical educator. She is a host on the Healing Hearts Podcast featuring her ongoing cardiac lesions series and produces MedEd videos on YouTube at DrOrtmannCICU.

References:

Ortmann LA, Keshary M, Bisselou KS, Kutty S, Affolter JT. Association Between Postoperative Dexmedetomidine Use and Arrhythmias in Infants After Cardiac Surgery. World J Pediatr Congenit Heart Surg. 2019 Jul;10(4):440-445. doi: 10.1177/2150135119842873. PMID: 31307294.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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Extracorporeal Cardiopulmonary Resuscitation (ECPR) with Dr. Lakshmi Raman

Objectives:

By the end of listening to this episode, learners should be able to:

Define ECPR.
Understand the rationale for ECPR in cardiopulmonary arrest in children.
Recognize aspects of high-quality ECPR.
Understand the patient selection, context and setting that is most appropriate for pediatric ECPR.
Recognize when it is appropriate to activate the ECPR team after pediatric cardiac arrest.
Understand the rationale of choosing the location of cannulation (i.e., peripheral vs. central).

About our guest:
Dr. Lakshmi Raman is a Professor of Pediatrics at UT Southwestern and a pediatric intensivist at Children’s Medical Center Dallas. She serves as the Medical Director of the Extracorporeal Membrane Oxygenation (ECMO) program at CMC. She is active in ELSO and serves as the Chair of Publications. She also co-authored the 2021 ELSO Pediatric ECPR guidelines.

References:

Guerguerian, Anne-Marie; Sano, Minako; Todd, Mark; Honjo, Osami; Alexander, Peta; Raman, Lakshmi. Pediatric Extracorporeal Cardiopulmonary Resuscitation ELSO Guidelines. ASAIO Journal: March 2021 - Volume 67 - Issue 3 - p 229-237
doi: 10.1097/MAT.0000000000001345

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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ECMO Anticoagulation with Dr. Ali McMichael and Dr. Lisa Settle--Part 2

After listening to this series, learners should be able to:

Briefly describe neonatal and pediatric developmental hemostasis.
Recognize the key differences in anticoagulation of neonates, children and adults.
Describe the advantages and disadvantages of commonly used anticoagulants: unfractionated heparin, bivalirudin and argatroban.
Describe common laboratory testing for anticoagulation on ECMO and their limitations: ACT, aPTT, anti Xa, VHAs
Troubleshoot discrepant anticoagulation laboratory testing.
Discuss future research in ECMO and anticoagulation

About our guests:

Dr. Ali McMichael who was previously with us here in Dallas is now an Associate Professor of Pediatrics at the University of Arizona and a pediatric intensivist at Phoenix Children’s Hospital. Her interests include medical education and ECMO anticoagulation. She is the first author of the 2021 ELSO Adult and Pediatric anticoagulation guidelines.

Dr. Lisa Settle is a pediatric critical care fellow at UT Southwestern and Children’s Medical Center in Dallas. Her research interests include anticoagulation management in ECMO, specifically focusing on the utilization of TEG data in the neonatal ECMO population.

References:

Levy JH, Staudinger T, Steiner ME. How to manage anticoagulation during extracorporeal membrane oxygenation. Intensive Care Med. 2022 Jun 11:1–4. doi: 10.1007/s00134-022-06723-z. Epub ahead of print. PMID: 35689697; PMCID: PMC9187844.

McMichael ABV, Ryerson LM, Ratano D, Fan E, Faraoni D, Annich GM. 2021 ELSO Adult and Pediatric Anticoagulation Guidelines. ASAIO J. 2022 Mar 1;68(3):303-310. doi: 10.1097/MAT.0000000000001652. PMID: 35080509.

Ryerson LM, McMichael ABV. Bivalirudin in pediatric extracorporeal membrane oxygenation. Curr Opin Pediatr. 2022 Jun 1;34(3):255-260. doi: 10.1097/MOP.0000000000001131. PMID: 35634698.

Saini A, Spinella PC. Management of anticoagulation and hemostasis for pediatric extracorporeal membrane oxygenation. Clin Lab Med. 2014 Sep;34(3):655-73. doi: 10.1016/j.cll.2014.06.014. Epub 2014 Jul 24. PMID: 25168949.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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PedsCrit stickers are now available! To get one, email your shipping information to PedsCritPodcast@gmail.com, DM Zac or Alice on Twitter, or DM the PedsCrit Instagram.

Email: PedsCritPodcast@gmail.com
Twitter: @ZHodges1, @AliceShanklin, @CritPeds
Instagram: @PedsCrit

If you'd like to support the show, you can send donations to @PedsCrit on Venmo or become a monthly subscriber to the PedsCrit Patreon.

Thank you for listening to PedsCrit. Please remember that all content is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes, and visit @critpeds on Twitter and @pedscrit on Instagram for real time show updates.

Support the show

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ECMO Anticoagulation with Dr. Ali McMichael and Dr. Lisa Settle--Part 1

After listening to this series, learners should be able to:

Briefly describe neonatal and pediatric developmental hemostasis.
Recognize the key differences in anticoagulation of neonates, children and adults.
Describe the advantages and disadvantages of commonly used anticoagulants: unfractionated heparin, bivalirudin and argatroban.
Describe common laboratory testing for anticoagulation on ECMO and their limitations: ACT, aPTT, anti Xa, VHAs
Troubleshoot discrepant anticoagulation laboratory testing.
Discuss future research in ECMO and anticoagulation

About our guests:

Dr. Ali McMichael who was previously with us here in Dallas is now an Associate Professor of Pediatrics at the University of Arizona and a pediatric intensivist at Phoenix Children’s Hospital. Her interests include medical education and ECMO anticoagulation. She is the first author of the 2021 ELSO Adult and Pediatric anticoagulation guidelines.

Dr. Lisa Settle is a pediatric critical care fellow at UT Southwestern and Children’s Medical Center in Dallas. Her research interests include anticoagulation management in ECMO, specifically focusing on the utilization of TEG data in the neonatal ECMO population.

References:

Levy JH, Staudinger T, Steiner ME. How to manage anticoagulation during extracorporeal membrane oxygenation. Intensive Care Med. 2022 Jun 11:1–4. doi: 10.1007/s00134-022-06723-z. Epub ahead of print. PMID: 35689697; PMCID: PMC9187844.

McMichael ABV, Ryerson LM, Ratano D, Fan E, Faraoni D, Annich GM. 2021 ELSO Adult and Pediatric Anticoagulation Guidelines. ASAIO J. 2022 Mar 1;68(3):303-310. doi: 10.1097/MAT.0000000000001652. PMID: 35080509.

Ryerson LM, McMichael ABV. Bivalirudin in pediatric extracorporeal membrane oxygenation. Curr Opin Pediatr. 2022 Jun 1;34(3):255-260. doi: 10.1097/MOP.0000000000001131. PMID: 35634698.

Saini A, Spinella PC. Management of anticoagulation and hemostasis for pediatric extracorporeal membrane oxygenation. Clin Lab Med. 2014 Sep;34(3):655-73. doi: 10.1016/j.cll.2014.06.014. Epub 2014 Jul 24. PMID: 25168949.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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By the end of this two-part series, listeners will be able to:

Verbalize a more progressive definition of palliative care, and distinguish it from "end-of-life" care or hospice care.
Define appropriate patient populations for referral to palliative care.
Sensitively and clearly introduce palliative care referral with patients and families.
Recognize the value of communication training, and verbalize a simple framework for difficult conversations.
Define the challenges of learning/practicing difficult communication as a resident/fellow, and elaborate some strategies to help mitigate these challenges.

About our guests:

Stockton Beveridge, M.D., is an Assistant Professor in the Department of Pediatrics in the Division of Developmental / Behavioral Pediatrics, serving as the director of Pediatric Palliative Care. Dr. Beveridge’s research interests have focused on the challenges faced by caregivers of children with medical complexity, particularly in the Latino population. He is additionally interested in the intersection of religion and medicine, particularly in medical crisis. He sits on the hospital’s Ethics Committee and is also the medical director for Schwartz Rounds.

Katie Maddox, M.D., is an Assistant Professor in the Department of Pediatrics in the Division of Developmental / Behavioral Pediatrics at UT Southwestern. She is a board-certified pediatric palliative care physician at Children’s Health Dallas. Her clinical and research interests relate to caring for children with special healthcare needs and communication skills training in medical education. Dr. Maddox has received the Educational Innovation Award for developing communication skills training and the Pediatric Society of Greater Dallas White Hat Award.

References:

Center to Advance Palliative Care--https://www.capc.org/

Childers JW, Back AL, Tulsky JA, Arnold RM. REMAP: A Framework for Goals of Care Conversations. J Oncol Pract. 2017 Oct;13(10):e844-e850. doi: 10.1200/JOP.2016.018796. Epub 2017 Apr 26. PMID: 28445100.

Gillis J. "We want everything done". Arch Dis Child. 2008 Mar;93(3):192-3. doi: 10.1136/adc.2007.120568. PMID: 18319382.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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By the end of this two-part series, listeners will be able to:

Verbalize a more progressive definition of palliative care, and distinguish it from "end-of-life" care or hospice care.
Define appropriate patient populations for referral to palliative care.
Sensitively and clearly introduce palliative care referral with patients and families.
Recognize the value of communication training, and verbalize a simple framework for difficult conversations.
Define the challenges of learning/practicing difficult communication as a resident/fellow, and elaborate some strategies to help mitigate these challenges.

About our guests:

Stockton Beveridge, M.D., is an Assistant Professor in the Department of Pediatrics in the Division of Developmental / Behavioral Pediatrics, serving as the director of Pediatric Palliative Care. Dr. Beveridge’s research interests have focused on the challenges faced by caregivers of children with medical complexity, particularly in the Latino population. He is additionally interested in the intersection of religion and medicine, particularly in medical crisis. He sits on the hospital’s Ethics Committee and is also the medical director for Schwartz Rounds.

Katie Maddox, M.D., is an Assistant Professor in the Department of Pediatrics in the Division of Developmental / Behavioral Pediatrics at UT Southwestern. She is a board-certified pediatric palliative care physician at Children’s Health Dallas. Her clinical and research interests relate to caring for children with special healthcare needs and communication skills training in medical education. Dr. Maddox has received the Educational Innovation Award for developing communication skills training and the Pediatric Society of Greater Dallas White Hat Award.

References:

Center to Advance Palliative Care--https://www.capc.org/

Childers JW, Back AL, Tulsky JA, Arnold RM. REMAP: A Framework for Goals of Care Conversations. J Oncol Pract. 2017 Oct;13(10):e844-e850. doi: 10.1200/JOP.2016.018796. Epub 2017 Apr 26. PMID: 28445100.

Gillis J. "We want everything done". Arch Dis Child. 2008 Mar;93(3):192-3. doi: 10.1136/adc.2007.120568. PMID: 18319382.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Support the show

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Dr. Yurasek is a graduate of the Columbia University College of Physicians and Surgeons. He completed his pediatric residency at Children’s Hospital of Boston followed by a pediatric cardiology fellowship also at Boston Children’s and a PICU fellowship at Massachusetts General Hospital. He is now a CICU attending and the director of critical care simulation at Children’s National Hospital in Washington, DC.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:1. Understand the preoperative anatomy that influences surgical plan and postoperative care in the cardiac intensive care unit (CICU).
2. Recall the goals and general steps of operative repair.
3. Recognize the key information provided in post-op handoff that will affect management.
4. Recognize important postoperative complications and develop an approach to their management.
5. Develop a mental framework of the expected postoperative CICU course with a focus on barriers to ICU discharge.

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About our Guest:Dr. Yurasek is a graduate of the Columbia University College of Physicians and Surgeons. He completed his pediatric residency at Children’s Hospital of Boston followed by a pediatric cardiology fellowship also at Boston Children’s and a PICU fellowship at Massachusetts General Hospital. He is now a CICU attending and the director of critical care simulation at Children’s National Hospital in Washington, DC.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:1. Understand the preoperative anatomy that influences surgical plan and postoperative care in the cardiac intensive care unit (CICU).
2. Recall the goals and general steps of operative repair.
3. Recognize the key information provided in post-op handoff that will affect management.
4. Recognize important postoperative complications and develop an approach to their management.
5. Develop a mental framework of the expected postoperative CICU course with a focus on barriers to ICU discharge.

Support the show

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About our Guest:Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:By the end of listening to this three-part series, learners should be able to:

Recall the diagnostic criteria for pediatric acute respiratory distress syndrome (PARDS).
Recall many of different direct and indirect causes of PARDS.
Recall the methods used to stratify the severity of PARDS.
Recognize the limitations of P/F ratios and the clinical utility of instead using oxygenation index (OI).
Describe the rationale and limitations of adjunctive therapies for moderate to severe PARDS.

Citations

Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(5):428-439. doi:10.1097/PCC.0000000000000350

Acute Respiratory Distress syndrome Incidence and Epidemiology (PARDIE) Investigators, & Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network (2019). Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study. The Lancet. Respiratory medicine, 7(2), 115–128. https://doi.org/10.1016/S2213-2600(18)30344-8

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates

Support the show

View Details

About our Guest:Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:By the end of listening to this three-part series, learners should be able to:

Recall the diagnostic criteria for pediatric acute respiratory distress syndrome (PARDS).
Recall many of different direct and indirect causes of PARDS.
Recall the methods used to stratify the severity of PARDS.
Recognize the limitations of P/F ratios and the clinical utility of instead using oxygenation index (OI).
Describe the rationale and limitations of adjunctive therapies for moderate to severe PARDS.

Citations

Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(5):428-439. doi:10.1097/PCC.0000000000000350

Acute Respiratory Distress syndrome Incidence and Epidemiology (PARDIE) Investigators, & Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network (2019). Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study. The Lancet. Respiratory medicine, 7(2), 115–128. https://doi.org/10.1016/S2213-2600(18)30344-8

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates

Support the show

View Details

About our Guest:Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:By the end of listening to this three-part series, learners should be able to:

Recall the diagnostic criteria for pediatric acute respiratory distress syndrome (PARDS).
Recall many of different direct and indirect causes of PARDS.
Recall the methods used to stratify the severity of PARDS.
Recognize the limitations of P/F ratios and the clinical utility of instead using oxygenation index (OI).
Describe the rationale and limitations of adjunctive therapies for moderate to severe PARDS.

Citations

Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(5):428-439. doi:10.1097/PCC.0000000000000350

Acute Respiratory Distress syndrome Incidence and Epidemiology (PARDIE) Investigators, & Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network (2019). Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study. The Lancet. Respiratory medicine, 7(2), 115–128. https://doi.org/10.1016/S2213-2600(18)30344-8

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates

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About our Guest:Samuel Mandell, M.D., M.P.H., is an Associate Professor in the Department of Surgery at UT Southwestern Medical Center. He specializes in trauma surgery, surgical critical care, and comprehensive care of burn-injured patients. Dr. Mandell also serves as Burn Section Chief and Director of the Parkland Regional Burn Center in Dallas, Texas.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:By the end of listening to this two-part series, learners should be able to:

Describe the key elements of the initial evaluation and resuscitation of the burn injured pediatric patient.
Recognize risk factors and clinical features of inhalation injury.
Recognize risk factors and clinical features of carbon monoxide and cyanide poisoning.
Estimate the total body surface area (TBSA) burned.
Recall general indications for transfer to a specialty burn center.

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About our Guest:Samuel Mandell, M.D., M.P.H., is an Associate Professor in the Department of Surgery at UT Southwestern Medical Center. He specializes in trauma surgery, surgical critical care, and comprehensive care of burn-injured patients. Dr. Mandell also serves as Burn Section Chief and Director of the Parkland Regional Burn Center in Dallas, Texas.

How to support PedsCrit:
Please rate and review on Spotify or Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:By the end of listening to this two-part series, learners should be able to:

Describe the key elements of the initial evaluation and resuscitation of the burn injured pediatric patient.
Recognize risk factors and clinical features of inhalation injury.
Recognize risk factors and clinical features of carbon monoxide and cyanide poisoning.
Estimate the total body surface area (TBSA) burned.
Recall general indications for transfer to a specialty burn center.

View Details

About our Guest:Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care and a practicing pediatric intensivist at the University of Florida.

How to support PedsCrit:
Please share, like, rate and review on Apple Podcasts or Spotify!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:

The participant will be able to discuss unique physiology of the neuromuscular patient and how it relates to work of breathing
The participant will be able to define obstacles to effective ventilation in patients with neuromuscular disease
The participant will be able to describe ventilation strategies to utilize in patients with neuromuscular disease

For a deeper dive on Disability Studies, check out Alice Wong's Disability Visibility Podcast: https://podcasts.apple.com/us/podcast/disability-visibility/id1282878324 References

1.Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177-89.

2.Mercuri E, Finkel RS, Muntoni F, Wirth B, Montes J, Main M, et al. Diagnosis and management of spinal muscular atrophy: Part 1: Recommendations for diagnosis, rehabilitation, orthopedic and nutritional care. Neuromuscul Disord. 2018;28(2):103-15.

3.Finkel RS, Mercuri E, Meyer OH, Simonds AK, Schroth MK, Graham RJ, et al. Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscul Disord. 2018;28(3):197-207.

4.Marino PL SK. The ICU Book. Wilkins LW, editor. Philadelphia: Lippincott Williams & Wilkins; 2007.

5.Machado DL, Silva EC, Resende MB, Carvalho CR, Zanoteli E, Reed UC. Lung function monitoring in patients with duchenne muscular dystrophy on steroid therapy. BMC Res Notes. 2012;5:435.

6.Wheeler DS, Wong HR, Zingarelli B. Pediatric Sepsis - Part I: "Children are not small adults!". Open Inflamm J. 2011;4:4-15.

7.Lo Mauro A, Aliverti A. Physiology of respiratory disturbances in muscular dystrophies. Breathe (Sheff). 2016;12(4):318-27.

8.Diaz CE, Deoras KS, Allen JL. Chest wall motion before and during mechanical ventilation in children with neuromuscular disease. Pediatr Pulmonol. 1993;16(2):89-95.

9.Perez A, Mulot R, Vardon G, Barois A, Gallego J. Thoracoabdominal pattern of breathing in neuromuscular disorders. Chest. 1996;110(2):454-61.

10.Testa MB, Pavone M, Bertini E, Petrone A, Pagani M, Cutrera R. Sleep-disordered breathing in spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2005;84(9):666-70.

11.Aboussouan LS. Sleep-disordered Breathing in Neuromuscular Disease. Am J Respir Crit Care Med. 2015;191(9):979-89.

12.Hull J, Aniapravan R, Chan E, Chatwin M, Forton J, Gallagher J, et al. British Thoracic Society guideline for respiratory management of children with neuromuscular weakness. Thorax. 2012;67 Suppl 1:i1-40.

13.Mayer O PH, Rhodes H, Dominick C, Wolfe H, Martin K, Craig N, Waxler M. . PICU Pathway for SMA Patient Admitted with Acute Respiratory Failure https://www.chop.edu/clinical-pathway/spinal-muscular-atrophy-sma-acute-respiratory-failure-clinical-pathway2019

14.Petrone A, Pavone M, Testa MB, Petreschi F, Bertini E, Cutrera R. Noninvasive ventilation in children with spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2007;86(3):216-21.

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**Ventilation of the Neuromuscular Patient with Dr. Bill Bortcosh--Part 1: physiology and noninvasive ventilation

About our Guest:**Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care and a practicing pediatric intensivist at the University of Florida.

How to support PedsCrit:
Please share, like, rate and review on Apple Podcasts or Spotify!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Objectives for this series:

The participant will be able to discuss unique physiology of the neuromuscular patient and how it relates to work of breathing
The participant will be able to define obstacles to effective ventilation in patients with neuromuscular disease
The participant will be able to describe ventilation strategies to utilize in patients with neuromuscular disease

References