#187 - đź«€Insights in Neonatal Cardiac Care (ft Dr. Nim Goldshtrom)
Mar 3, 2024
58:52
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Dive into neonatal cardiac care with Dr. Nim Goldshtrom, discussing specialized training, technology like NIRS, genetic screening challenges, and future directions in the field. Learn about the journey of a pediatric cardiac care specialist, the structure of a neonatal cardiac ICU, and advancements in care for fragile patients.
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Quick takeaways
Focused training in neonatal cardiac care is essential for improving outcomes for infants with congenital heart disease.
Collaboration between neonatology and cardiology is crucial for providing specialized care in neonatal cardiac ICUs.
Utilizing near-infrared spectroscopy (NIRS) can aid in early detection of deteriorating patient physiology and improve overall outcomes.
Deep dives
Discovering Interest in NICU and Cardiac Care
The guest, Dr. Nimrod Golschram, discusses his journey into neonatology and pediatric cardiac intensive care, revealing initial hesitation towards NICU and unexpected shifts in career interests. Starting with aspirations in emergency medicine, his exposure to NICU and later cardiac care during residency and fellowship led to a deep appreciation for child-centered care and critical illnesses, shaping his career path.
Specialized Training in Pediatric Cardiac Intensive Care
Dr. Golschram elaborates on additional training in pediatric cardiac intensive care, highlighting the distinctive skill set required, including insights into managing congenital heart disease cases in various age groups. He emphasizes the importance of exposure, mentorship, and tailoring training pathways to acquire expertise in cardiac and neonatal care, paving the way for comprehensive patient-centered approaches and improved outcomes.
Integrating Neonatology into Neonatal Cardiac ICU Model
The discussion delves into the development of a neonatal cardiac ICU unit, emphasizing collaboration between neonatology and cardiology to enhance specialized care for infants with congenital heart disease. Dr. Golschram underscores the value of co-horted units led by dual-trained professionals, fostering teamwork among neonatal nurses, neonatal practitioners, and cardiologists for holistic patient management. The model supports unique monitoring techniques like near-infrared spectroscopy, showcasing its clinical utility in identifying critical states and influencing practices in standard NICU settings.
Improving Patient Outcomes with Near-Infared Spectroscopy (NIRS)
The implementation of Near-Infared Spectroscopy (NIRS) in the cardiac unit has significantly reduced the incidence of cardiac arrests. By using NIRS to monitor patients' circulation, the medical team has been able to detect early signs of deteriorating physiology. This tool has not replaced traditional monitoring methods but serves as an additional valuable indicator in assessing patient status. NIRS has been extended to the general NICU, demonstrating its utility in improving patient outcomes and enabling a holistic approach to patient care.
Enhancing Neonatal Care Through Future Innovations
The future of neonatal care includes utilizing genetic screening tools to enhance decision-making and provide families with valuable information about their child's health risks. These tools offer insights into complex congenital heart disease and other conditions, aiding in better risk assessment and treatment planning. Additionally, advancements in neuroprotective measures and outcomes-driven research are crucial for improving long-term neurological outcomes in neonates. Creating a supportive environment for families post-discharge, where they receive ongoing education and emotional support, is identified as a key factor in enhancing patient outcomes and overall care quality.
In this week’s episode of The Incubator Podcast, hosts Ben Courchia, MD, and Daphna Yasova Barbeau, MD, dive into the complex world of neonatal care for infants with congenital heart disease.
Our guest, Dr. Nim Goldshtrom, shares insights from his extensive experience in neonatology and pediatric cardiac intensive care, focusing on the multidisciplinary approach to caring for the sickest infants at Columbia University Irving Medical Center and Morgan Stanley Children’s Hospital. Dr. Goldshtrom discusses the evolution of his career, the importance of specialized training for dealing with congenital heart disease in neonates, and how modern technology like near-infrared spectroscopy (NIRS) is being used to improve patient outcomes. The conversation also touches on the challenges and opportunities presented by genetic screening and the future directions of neonatal and congenital heart disease care. Join us for an enlightening discussion that sheds light on the nuanced care required for these vulnerable patients and the ongoing advancements in the field.
As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.
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