PedsCrit

Welcome to PedsCrit! We are a collaborative educational PICU podcast working with pediatric critical care educators around the world to create high-yield podcast episodes on core PICU topics. Find us at PedsCrit.com, or reach us via email at [email protected]. We hope you enjoy!No conflicts of interest.Each clinical episode is made in coordination with a pediatric intensivist or guest that is otherwise a clinical or scholarly leader on the topic being discussed. Podcasts do not receive formal peer review prior to publication but quality and accuracy is closely monitored throughout the creation process. If you have any comments, suggestions, or feedback-you can email us at [email protected]. You can also find us on twitter visit @critpeds and @pedscrit on instagram.Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo, you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions.Thank you for listening to PedsCrit!-Alice Shanklin & Zac Hodges

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Top 10 PedsCrit Episodes

Goodpods has curated a list of the 10 best PedsCrit episodes, ranked by the number of listens and likes each episode have garnered from our listeners. If you are listening to PedsCrit for the first time, there's no better place to start than with one of these standout episodes. If you are a fan of the show, vote for your favorite PedsCrit episode by adding your comments to the episode page.

Natural Airway Sedation with Pradip Kamat, Part 1

PedsCrit

08/12/21 • 25 min

Dr. Pradip Kamat is an Associate Professor of Pediatrics at Emory School of Medicine and practicing pediatric intensivist at Children's Healthcare of Atlanta. His clinical and research interests are in procedural sedation and education. We are very excited to have him on our podcast.
Dr. Kamat is also active in PICU open access education. Please check out the PICU Doc On Call podcast co-hosted by Rahul Damania and him at https://picudoconcall.org
During our conversation we discuss:
1. Why this topic is so important for PICU physicians
2. Procedural sedation vs. general anesthesia
3. Conscious sedation???
4. Safety considerations, risk factors and adverse events
5. Patient selection
6. Drug selection
7. Appropriate monitoring
8. Rescue medications.

References and further reading:
Coté CJ, Wilson S; AMERICAN ACADEMY OF PEDIATRICS; AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatrics. 2016 Jul;138(1):e20161212. doi: 10.1542/peds.2016-1212. PMID: 27354454.
Emrath ET, Stockwell JA, McCracken CE, Simon HK, Kamat PP. Provision of deep procedural sedation by a pediatric sedation team at a freestanding imaging center. Pediatr Radiol. 2014 Aug;44(8):1020-5. doi: 10.1007/s00247-014-2942-z. Epub 2014 May 24. PMID: 24859263.
Grunwell JR, McCracken C, Fortenberry J, Stockwell J, Kamat P. Risk factors leading to failed procedural sedation in children outside the operating room. Pediatr Emerg Care. 2014 Jun;30(6):381-7. doi: 10.1097/PEC.0000000000000143. PMID: 24849275.
Hooper MC, Kamat PP, Couloures KG. Evaluating the Need for Pediatric Procedural Sedation Training in Pediatric Critical Care Medicine Fellowship. Pediatr Crit Care Med. 2019 Mar;20(3):259-261. doi: 10.1097/PCC.0000000000001809. PMID: 30431555.
Kamat PP, McCracken CE, Simon HK, Stormorken A, Mallory M, Chumpitazi CE, Cravero JP. Trends in Outpatient Procedural Sedation: 2007-2018. Pediatrics. 2020 May;145(5):e20193559. doi: 10.1542/peds.2019-3559. PMID: 32332053.

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

Support the show

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

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

Mechanical Ventilation in Status Asthmaticus Part 1 with Dr. Mekela Whyte-Nesfield

PedsCrit

02/06/23 • 31 min

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

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

References:

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

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

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Disorders of Metabolism with Dr. Deb Regier (Part 1)

PedsCrit

10/14/24 • 47 min

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 ATP

2. Describe the science behind the main diagnostic tests for inborn errors of metabolism

3. Explain the presenting symptoms and initial management of common, life-threatening inborn errors of metabolism.

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

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Disorders of Metabolism with Dr. Deb Regier (Part 2)

PedsCrit

10/21/24 • 27 min

About our Guest:

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 ATP

2. Describe the science behind the main diagnostic tests for inborn errors of metabolism

3. Explain the presenting symptoms and initial management of common, life-threatening inborn errors of metabolism.

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

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Hemorrhagic Shock with Dr. Matthew Borgman

PedsCrit

11/18/24 • 48 min

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 & Zac

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ICU Liberation with Dr. Kristina Betters & Dr. Brooke Light -- Part 1

PedsCrit

12/02/24 • 30 min

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

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

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

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

References:

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

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

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An Expert Approach to Sedation and Early Mobility with Dr. Sapna Kudchadkar -- Part 1

PedsCrit

01/06/25 • 55 min

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.0000000000002324

2. Traube, C., Silver, G., Kearney, J., Patel, A., Atkinson, T. M., Yoon, M. J., Halpert, S., Augenstein, J., Sickles, L. E., Li, C., & Greenwald, B. (2014). Cornell Assessment of Pediatric Delirium. Critical Care Medicine, 42(3), 656–663. https://doi.org/10.1097/CCM.0b013e3182a66b76

3. 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 & Zac

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From the Battlefield to the Bedside: The Past, Present, and Future of Blood Product Resuscitation with Dr. Phil Spinella -- Part 2

PedsCrit

02/24/25 • 42 min

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 & Zac

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Atrioventricular Septal Defects with Dr. Melinda Cory

PedsCrit

12/19/22 • 32 min

Melinda Cory, M.D., is an Assistant Professor in the Department of Pediatrics at UT Southwestern Medical Center. She earned her medical degree at UT Southwestern, where she also completed her residency in pediatrics. She gained advanced training through fellowships in pediatric cardiology and pediatric critical care medicine at Emory University School of Medicine.

Board certified in pediatrics, pediatric cardiology, and pediatric critical care, she attends in the cardiovascular intensive care unit at Children's Medical Center in Dallas, TX. She is also very active in medical education including serving as the associate program director for the pediatric cardiology fellowship program and helps lead the pediatric critical care simulation team.

Learning objectives:
After listening to this episode on atrioventricular septal defects, learners should be able to:

Recognize the relevant preoperative anatomy that influences operative plan and postoperative care in the cardiac intensive care unit (CICU).
Recall the goals and general options for operative repair.
Recognize the key information provided in surgical and anesthesia handover that will affect postoperative management.
Recognize the common and important postoperative complications and develop an approach to their management.
Develop a mental framework of the expected postoperative CICU course with a focus on common or important barriers to ICU discharge.

References:
Atrioventricular Septal Defects. Peter Sassalos MD, Ming-Sing Si MD, Richard G. Ohye MD, Edward L. Bove MD and Jennifer C. Romano MD, MS. Critical Heart Disease in Infants and Children, 50, 606-614.e2
Peterson JK, Setty SP, Knight JH, Thomas AS, Moller JH, Kochilas LK. Postoperative and long-term outcomes in children with Trisomy 21 and single ventricle palliation. Congenit Heart Dis. 2019 Sep;14(5):854-863. doi: 10.1111/chd.12823. Epub 2019 Jul 22. PMID: 31332952; PMCID: PMC7329297.

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

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United States PICU Physician Workforce with Dr. Chris Horvat

PedsCrit

07/29/24 • 33 min

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

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

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

References

1. Leslie LK, Orr CJ, Turner AL, et al. Child Health and the US Pediatric Subspecialty Workforce: Planning for the Future. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678B

2. Horvat CM, Hamilton MF, Hall MW, McGuire JK, Mink RB. Child Health Needs and the Pediatric Critical Care Medicine Workforce: 2020–2040. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678G

3. Fraher E, Knapton A, McCartha E, Leslie LK. Forecasting the Future Supply of Pediatric Subspecialists in the United States: 2020–2040. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678C

4. Horak R V., Marino BS, Werho DK, et al. Assessment of physician training and prediction of workforce needs in paediatric cardiac intensive care in the United States. Cardiol Young. 2022;32(11):1748-1753. doi:10.1017/S1047951121004893

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

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FAQ

How many episodes does PedsCrit have?

PedsCrit currently has 121 episodes available.

What topics does PedsCrit cover?

The podcast is about Life Sciences, Icu, Pediatrics, Critical Care, Podcast, Podcasts, Education, Science and Emergency Medicine.

What is the most popular episode on PedsCrit?

The episode title 'VV ECMO Part 3: Troubleshooting the circuit & preparing for early rehab' is the most popular.

What is the average episode length on PedsCrit?

The average episode length on PedsCrit is 33 minutes.

How often are episodes of PedsCrit released?

Episodes of PedsCrit are typically released every 10 days, 22 hours.

When was the first episode of PedsCrit?

The first episode of PedsCrit was released on Jun 30, 2021.

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PedsCrit

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Top 10 PedsCrit Episodes

FAQ

How many episodes does PedsCrit have?

What topics does PedsCrit cover?

What is the most popular episode on PedsCrit?

What is the average episode length on PedsCrit?

How often are episodes of PedsCrit released?

When was the first episode of PedsCrit?

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