Dr. Audrey Miller, an Attending Neonatologist at Nationwide Children's Hospital, shares her expertise on bronchopulmonary dysplasia (BPD). She discusses the complexities of managing BPD in the ICU, emphasizing individualized care strategies. Insights into ventilatory management, patient comfort, and weaning processes are explored, highlighting the importance of collaboration among healthcare teams. Additionally, she addresses the challenges of patient-ventilator asynchrony and the critical support needed for families navigating their child's care journey.
56:14
forum Ask episode
web_stories AI Snips
view_agenda Chapters
auto_awesome Transcript
info_circle Episode notes
question_answer ANECDOTE
Nationwide's Dedicated BPD ICU
Nationwide Children's runs a 24-bed dedicated BPD ICU that admits ~120–130 patients yearly and accepts national referrals.
Their unit reports low mortality, low trach rates, good neurodevelopment, and a dedicated multidisciplinary team.
insights INSIGHT
Heterogeneous Lung Physiology
BPD lungs are heterogeneous with few healthy units and many high-resistance, air-trapping regions.
These areas have long time constants so exhalation, not inhalation, often limits ventilation.
insights INSIGHT
Chronic Phase Ventilation Differs From ARDS
BPD requires long inspiratory time and very long expiratory time to ventilate high-resistance regions.
That physiology leads to low ventilator rates and higher tidal volumes than acute lung strategies.
Get the Snipd Podcast app to discover more snips from this episode
Audrey Miller, MD, is an Attending Neonatologist at Nationwide Children's Hospital and an Assistant Professor of Pediatrics at The Ohio State University College of Medicine. Dr. Miller’s clinical interests focus on bronchopulmonary dysplasia (BPD) and improving outcomes for patients with this disease. Dr. Miller serves as Medical Director for the inpatient BPD unit at Nationwide Children’s. Dr. Miller also serves as chair for the advocacy committee of the international BPD collaborative.
By the end of this podcast, listeners should be able to:
Define BPD and describe the underlying pathophysiology, risk factors and clinical trajectory.
Develop a clinical approach to mechanical ventilation in infants with BPD.
Describe strategies for mitigating compilations and promoting well-being in infants with severe BPD.
Reference:
Miller AN, Kielt MJ, El-Ferzli GT, Nelin LD, Shepherd EG. Optimizing ventilator support in severe bronchopulmonary dysplasia in the absence of conclusive evidence. Front Pediatr. 2022 Nov 24;10:1022743.
How to support PedsCrit: Please complete our Listener Feedback Survey Please rate and review on Spotify and Apple Podcasts! Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.
Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
PedsCrit