The PicPod

Major traumatic brain injury is a huge issue for Paediatric Intensive Care. We have machines for almost every organ: but the brain is on its own. Shruti Agrawal, consultant in paediatric intensive care in Addenbrookes Hospital, Cambridge, is first author on the Starship study, recently published in the Lancet eClinical […]

“Saving lives” is what we do. But at what cost? Are we threatening the survival of the world by our PIC practices? What's the point of healthcare, if we are destroying the world's future for those same children? We talked to Heather Baid, an ICU nurse and lead for sustainability […]

Nudge nudge…. a favourite of politicians and social commentators, but how can nudge technology help us in ventilation weaning? Lisa McIlmurray has been working on a pilot study of nudge technology attached to a ventilator. How does this help to move patients on? What are the algorithms used in this […]

Change is hard….isn't it? We spoke to Rebecca Lawton, a professor of Psychology from the University of Leeds, who is an expert in patient safety; behaviour change; improvement science; workforce engagement and wellbeing. Why is change so difficult? Who is it most difficult for? And how do we convince individuals, […]

First, do no harm… How much of the things we do every day are worthwhile? We all do so many interventions, but are they actually worthwhile? Some may be ineffective, some inefficient, and some may be harmful. But which is which? How do we find out whether we should, or […]

Calum Semple is a respiratory and infectious disease professor in Liverpool. He has been part of the governmental advice team for pandemics since before COVID. We spoke to him in advance of his talk at the 2024 PCCS conference What is the frequency of pandemics? Is the 2018 Spanish Flu […]

Nicola Disma, an anaesthetist in Genoa, Italy, is lead author on the European Society of Anaesthesiology and Intensive Care guidelines on airway management in neonates and infants, published in full text here. We discussed all things airway. Video laryngoscopes: useful, mandatory, or deskilling? “Normal” video blade or hyperangulated? Oxygen during […]

What's the point of evidence? It's to gain knowledge, so that we can treat our patients better. But what happens when the data is wrong, faked, misleading, or simply made up? Retraction Watch (www.retractionwatch.com, and @retractionwatch) collates retractions from journals around the world. Their database makes terrifying reading: tens of […]

From the 2023 PediCritiCon conference in Pune, India, I was lucky enough to chat with Bala Ramachandran from Chennai. He gave a great talk on precision medicine, its implications, and what the future may hold. What's the difference between personalised medicine and precision medicine? How does it differ to “usual” […]

Much research is technical and esoteric. Some research is fundamental and answers questions we want to answer every day. Often the first is easy to do (just add a lab and equipment), but the second is really, really hard. Mark Peters and team have just published the OxyPICU trial in […]

PicPod went to the 2023 PediCritiCon conference in Pune, India. It was a superb conference full of content, learning, and Bollywood dancing…! We sat down with Brenda Morrow, Professor of Paediatrics at the Red Cross Hospital in Cape Town, physiotherapist, and president of the World Federation of Paediatric Intensive and […]

At the PCCS2023 conference Harish and I were delighted to be invited to be a part of the conference. We were interviewed on stage by Zoltan Gyorgyi and Peter Donnelly, who asked us about the birth of PicPod, the process, and some highlights and lowlights. Unfortunately questions from the audience […]

At the PCCS2023 conference in Edinburgh, we were lucky enough to meet David Cooper from Cincinnati Children's Hospital. He gave a great talk on high reliability teams, and afterwards we chatted to him about his programme. We discuss hierarchies: when are hierarchies good, and when are they bad? Is democracy […]

One of the most entertaining talks at the 2023 Paediatric Critical Care Society Conference was by Roddy O'Kane, consultant neurosurgeon in Glasgow, on the management of ICP. On the theme of the conference, he was very clear: proper management of ICP depends on excellent team work, and listening to all […]

At the 2023 PCCS conference in Edinburgh we chatted to Marie Spiers, Emergency Department consultant in Glasgow, about paediatric traumatic cardiac arrest. How does traumatic cardiac arrest differ to medical cardiac arrest? Is the treatment different? What should we be focusing on? What is the point in chest compressions, and […]

Every day we go round the patients, making clear, robust plans so that the day works like clockwork. However, do you know how much of this information sticks with the team? It's a shockingly low percentage (even JUST AFTER the plan has been made). Listen to Lindsey who spoke at […]

In conjunction with the 2023 Paediatric Critical Care Society Conference in Edinburgh, we have interviewed Cathy MacDonald, one of the keynote speakers. Cathy has had a long career as a police hostage and crisis negotiator. What can she teach us about crisis negotiation? What are the parallels between her world […]

This year's Paediatric Critical Care Society conference in Edinburgh is a sell-out blockbuster. We spoke to Chris Kidson, part of the organising committee, to go over some of the highlights. These range from a hostage negotiator, talks about nutrition, debates on APRV, transfers to Norway, Scottish country dancing, and an […]

In this episode of PicPod we speak to David Inwald, the Chief Investigator of the Pressure Study. This landmark study is looking in to blood pressure targets, randomising critically ill children to normal care, or the 5th centile population blood pressure norm. We discuss the study, its rationale, and what […]

How many times have we discussed fluid balance on a ward round? What is our fluid goal? And why? Offloading fluid is a “good thing”, but why? And when? What does the evidence say: what balance should we be aiming at, and when? Does the evidence actually give a message […]

Liz Whittaker, consultant in Infectious diseases at St Mary's Hospital in London, talks to us about Group A Strep in children. Over the past month or so the UK has had a huge surge in invasive Group A Streptococcal infection in children. Trainees up and down the country have rapidly […]

We all “know” of the clear respiratory support escalator: air, oxygen, CPAP, BiPAP, Invasive ventilation. But where does High Flow fit in? What parameters should we use to determine when and how to use it? Ram from Imperial/St Mary's in London led the two-armed First ABC trial, the largest and […]

Without statistics, studies are just words. We need some way of translating data in to messages. More and more we read about studies which are using the mysterious Bayesian approach. How does this compare to the standard “frequentist” approach? What are the differences in data collection, analysis, messaging, and interpretation? […]

Everyone has now heard of Cytokine Storms. It's the thing with Covid: and why Covid was so severe in so many patients. However, what is a cytokine storm? What are the “good” cytokines, and what are the “bad” ones? How do we differentiate, and what can we do about it? […]

Our second podcast linked to the 2022 PCCS Conference in Leicester, September 2022, with Mike Farquhar, sleep consultant at Evelina Children's Hospital, and Sapna Kudchadkar from Johns Hopkins. This podcast went live at the time of Mike's talk at the conference. Take a walk around a paediatric intensive care unit. […]

Big Data. Artificial Intelligence. Machine Learning. All very 2022, all very trendy. But how can this help our practice in Paediatric Intensive Care? Heather Duncan, consultant intensivist in Birmingham, has been working for many years with AI and Machine Learning, including input from the MacLaren F1 team. What is Big […]

Coming this September: a proper face to face conference IS BACK! The 2022 Paediatric Critical Care Society Conference, held in Leicester on the 14-16th September 2022, will be packed full of mind-expanding workshops, cross cutting plenary topics, and focussed sessions on a breadth of PCC issues for all members of […]

Severe TBI is a difficult, frustrating condition to treat. The secondary injury process occurs despite our best efforts: and our monitoring tools are incredibly blunt. Physiological parameters change when it's too late: ICP is a localised and at times unreliable measure. CPP is two steps away from cerebral blood flow. […]

For the June Paediatric Critical Care Society Hot Topics Webinar series, we have interviewed one of the the speakers Barney Scholefield from Birmingham, an expert in the field of Post Cardiac Arrest care. First of all: what is cardiac arrest? How do we define it, and how do we classify […]

We were invited to chair a session at the 2022 Paediatric Critical Care Society Study Group meeting at St Mary's Hospital in London. This is a national meeting of research interested PIC clinicians. Two excellent speakers contributed. Chris Gale is a neonatologist who has led the WHEAT trial, in to […]

Paediatric Acute Respiratory Distress Syndrome (PARDS) is one of the very difficult situations which paediatric intensivists fear. As part of the UK Paediatric Critical Care Society Hot Topics series, this PicPod episode interviews Heidi Flori, Clinical Associate Professor at the University of Michigan, and PALICC member, who was a speaker […]

We are pleased to announce that in the coming weeks the UK Paediatric Critical Care Society (https://pccsociety.uk/, @PICSociety, soon to be @PCCSociety) is going to be joining up its educational resources run by its members. In this short podcast we explain the strategy. First we have Akash Deep, chair of […]

Some conditions are rare. Some conditions are difficult to understand. Some conditions are difficult to treat. ADEM is all 3. A sometimes devastating condition affecting completely normal children, ADEM is an upsetting and challenging condition. Treatment this aggressively is important. Mainstays of treatment are steroids, IVIG, and plasma exchange. But: […]

PicPod 55 was all about Lactate: this one's about the opposite (in some ways): Oxygen. Mark Peters is a professor of Paediatric Intensive Care at Great Ormond St Hospital in London. He is leading the Oxy-PICU trial, looking at whether a targeted saturation of 88-92% is different to 94-98% in […]

Lactate, the intensivist's friend and the athlete's enemy. As intensivists we always ask about the lactate as it's a great indicator of problems afoot. But where does it come from? What does it signify? Is lactate itself actually bad? Does it cause damage? Does CRRT reduce lactate (hint: yes, but […]