Defining Failure of First‑line Support and Next Steps

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

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

Learning Objective:

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

References:

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

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

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

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

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

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

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

Shein SL, Rotta AT. Long-term Neurocognit

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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.