PedsCrit

We are so thankful for help from our guests:Melissa (MJ) Sacco, MDAndrew Parsons, MDLearning 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. Citation:Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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.11193Hassinger 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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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.11193Hassinger 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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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.0000000000004220Patient-Ventilator Dyssynchrony • LITFL • CCC VentilationCitation:Rehder K, Hodges Z, Shanklin A. Patient-Ventilator Asynchrony. PedsCrit. Online Podcast. 04/2025. [insert link]Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 2025Learning 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.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 2025Learning 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.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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/continuumHakimi, R. (2023). Imaging of Central Nervous System Hemorrhage. http://journals.lww.com/continuumJordan, J. T., & Gerstner, E. R. (2023). Imaging of Brain Tumors. http://journals.lww.com/continuumBarnette, 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.2013-4247Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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/continuumHakimi, R. (2023). Imaging of Central Nervous System Hemorrhage. http://journals.lww.com/continuumJordan, J. T., & Gerstner, E. R. (2023). Imaging of Brain Tumors. http://journals.lww.com/continuumBarnette, 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.2013-4247Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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)Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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. Dr. Spinella is a well-established clinical trialist who has published extensively in the field and contributed to research programs for the FDA, NIH, and DoD. He also co-founded the THOR network for trauma and hemostasis research and has 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)Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 5Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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: 1. Discuss the best ways to prevent delirium in young children, including sedative medication selection and non-pharmacologic techniques.2. 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.3. Discuss how to obtain hospital resources to support early mobilization and motivate a team to accomplish these goals.Selected References: 1. 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.00000000000023242. 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.0b013e3182a66b763. 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.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 bundleReferences: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. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 bundleReferences: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. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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. Moore et al. Fibrinolysis Shutdown in Trauma: Historical Review and Clinical Implications. Anesth Analg. 2019 Sep;129(3):762-773.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.Whitton TP, Healy WJ. Clinical Use and Interpretation of Thromboelastography. ATS Sch. 2023 Jan 9;4(1):96-97. MATIC-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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 settingThe basic pathophysiology of each acid-base disturbanceThe definition of an anion gap and how to use it as a screening toolThe use of Winter's formula to identify a respiratory acidosis or alkalosisThe utility of the delta-delta to identify additional metabolic acidosis or alkalosisLink to Acid/Base HandoutReferences1. Carmody JB, Norwood VF. A clinical approach to paediatric acid-base disorders. Postgrad Med J. 2012;88(1037):143-51.2. Carmody JB, Norwood VF. Paediatric acid-base disorders: A case-based review of procedures and pitfalls. Paediatr Child Health. 2013;18(1):29-32.3. Emmett M. Approach to the Patient With a Negative Anion Gap. Am J Kidney Dis. 2016;67(1):143-50.4. Luke RG, Galla JH. It is chloride depletion alkalosis, not contraction alkalosis. J Am Soc Nephrol. 2012;23(2):204-7.5. https://emcrit.org/ibcc/salicylates/Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 settingThe basic pathophysiology of each acid-base disturbanceThe definition of an anion gap and how to use it as a screening toolThe use of Winter's formula to identify a respiratory acidosis or alkalosisThe utility of the delta-delta to identify additional metabolic acidosis or alkalosisLink to Acid/Base HandoutReferences1. Carmody JB, Norwood VF. A clinical approach to paediatric acid-base disorders. Postgrad Med J. 2012;88(1037):143-51.2. Carmody JB, Norwood VF. Paediatric acid-base disorders: A case-based review of procedures and pitfalls. Paediatr Child Health. 2013;18(1):29-32.3. Emmett M. Approach to the Patient With a Negative Anion Gap. Am J Kidney Dis. 2016;67(1):143-50.4. Luke RG, Galla JH. It is chloride depletion alkalosis, not contraction alkalosis. J Am Soc Nephrol. 2012;23(2):204-7.5. https://emcrit.org/ibcc/salicylates/Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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:1. List the three main metabolic pathways and describe how they work together to make ATP2. Describe the science behind the main diagnostic tests for inborn errors of metabolism3. 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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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:1. List the three main metabolic pathways and describe how they work together to make ATP2. Describe the science behind the main diagnostic tests for inborn errors of metabolism3. 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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 CRRTCommon anticoagulation strategies in CRRTGeneral 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 & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 CRRTCommon anticoagulation strategies in CRRTGeneral 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. EpubQuestions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 ObjectivesAfter 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 bQuestions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 ObjectivesAfter 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 InfQuestions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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.References1.     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.2023-063678B2.     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.2023-063678G3.     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.2023-063678C4.     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/S1047951121004893Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 SurveyPlease 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

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 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Support the show

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 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.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Support the show

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

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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

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 showSupport the show

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

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.com for 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

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.com for 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—The PICS-p Framework*. Pediatric Critical Care Medicine 19(4):p 298-300, April 2018. | DOI: 10.1097/PCC.0000000000001476 https://www.palisi.org/ Killien EY, Zimmerman JJ, Di Gennaro JL, Watson RS. Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor. 2022 Jun 15;4(6):e0716. doi: 10.1097/CCE.0000000000000716. PMID: 35733611; PMCID: PMC9203075.Smith MB, Killien EY, Dervan LA, Rivara FP, Weiss NS, Watson RS. The association of severe pain experienced in the pediatric intensive care unit and postdischarge health-related quality of life: A retrospective cohort study. Paediatr Anaesth. 2022 Aug;32(8):899-906. doi: 10.1111/pan.14460. Epub 2022 Apr 22. PMID: 35426458; PMCID: PMC9990726.Support the show

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.com for 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—The PICS-p Framework*. Pediatric Critical Care Medicine 19(4):p 298-300, April 2018. | DOI: 10.1097/PCC.0000000000001476 https://www.palisi.org/ Killien EY, Zimmerman JJ, Di Gennaro JL, Watson RS. Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor. 2022 Jun 15;4(6):e0716. doi: 10.1097/CCE.0000000000000716. PMID: 35733611; PMCID: PMC9203075.Smith MB, Killien EY, Dervan LA, Rivara FP, Weiss NS, Watson RS. The association of severe pain experienced in the pediatric intensive care unit and postdischarge health-related quality of life: A retrospective cohort study. Paediatr Anaesth. 2022 Aug;32(8):899-906. doi: 10.1111/pan.14460. Epub 2022 Apr 22. PMID: 35426458; PMCID: PMC9990726.Support the show

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.com for 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 hypothermia after out-of-hospital cardiac arrest in children. N Engl J Med. 2015 May 14;372(20):1898-908. doi: 10.1056/NEJMoa1411480. Epub 2015 Apr 25. PMID: 25913022; PMCID: PMC4470472.Moler et al; THAPCA Trial Investigators. Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children. N Engl J Med. 2017 Jan 26;376(4):318-329. doi: 10.1056/NEJMoa1610493. Epub 2017 Jan 24. PMID: 28118559; PMCID: PMC5310766.Support the show

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.com for 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 hypothermia after out-of-hospital cardiac arrest in children. N Engl J Med. 2015 May 14;372(20):1898-908. doi: 10.1056/NEJMoa1411480. Epub 2015 Apr 25. PMID: 25913022; PMCID: PMC4470472.Moler et al; THAPCA Trial Investigators. Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children. N Engl J Med. 2017 Jan 26;376(4):318-329. doi: 10.1056/NEJMoa1610493. Epub 2017 Jan 24. PMID: 28118559; PMCID: PMC5310766.Support the show

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-profilehttps://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covidhttps://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 2019Nirmal 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 OxygenationPalen 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

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.ObjectivesBy the end of this podcast series, listeners should be able to:     Strategize how to approach an arrest as the code leaderRecognize the key elements of high-quality CPR and how to optimize perfusion during an arrest Recall airway management, oxygenation, and ventilation during CPRRecall different approaches to physiological monitoring during an arrest to guide therapy      Recognize appropriate resuscitation drug administration and timing during CPRRecall management with manual defibrillation for arrests with a shockable rhythmDevelop approach to determining code duration and when to discontinue CPRHow to support PedsCritPlease 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

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.ObjectivesBy the end of this podcast series, listeners should be able to:     Strategize how to approach an arrest as the code leaderRecognize the key elements of high-quality CPR and how to optimize perfusion during an arrest Recall airway management, oxygenation, and ventilation during CPRRecall different approaches to physiological monitoring during an arrest to guide therapy      Recognize appropriate resuscitation drug administration and timing during CPRRecall management with manual defibrillation for arrests with a shockable rhythmDevelop approach to determining code duration and when to discontinue CPRHow to support PedsCritPlease 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