PedsCrit

This episode is produced in collaboration with WFPICCS (the World Federation of Pediatric Intensive and Critical Care Societies) showcasing the talks you can look forward to at WFPICCS 2026 in Melbourne, September 27–30. Dr. Sarah Seaton is an Associate Professor in Perinatal and Paediatric Research at the University of Leicester in the UK. She earned her undergraduate degree in Mathematics from the University of Wales, followed by a MSc in Medical Statistics and a PhD at Leicester. Dr. Seaton serves as the co-principal investigator of the Paediatric Intensive Care Audit Network (PICANet), an international audit of all paediatric intensive care delivered in the UK and Ireland. Prior to PICANet, she held three fellowships funded by the National Institute for Health Research, including an Advanced Fellowship in 2024 which aimed to investigate the transition from neonatal to paediatric care.Reference:https://www.picanet.org.uk/Send us Fan MailSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease 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. If you have any comments, suggestions, or feedback-you can email us at [email protected].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Ryan Coleman, Associate Professor at Baylor and pediatric ECMO and pulmonary hypertension specialist, joins to discuss high‑risk pediatric pulmonary embolism. He explains right ventricular failure physiology, echo findings that change management, airway and resuscitation strategies, when to use inhaled vasodilators, and the role of early ECMO and coordinated PE response teams.

Charles Berde, a Harvard pediatric anesthesiologist and pediatric pain specialist, explores local anesthetic systemic toxicity in children. He covers sodium-channel toxicity, warning signs, relative drug risks, pediatric vulnerabilities, and prevention of intravascular injection. The discussion also addresses lipid rescue, seizure management, resuscitation priorities, and when to activate ECMO for refractory cardiovascular collapse.

Fran Balamuth, pediatric sepsis researcher at CHOP; Scott Weiss, critical care chief and sepsis expert at Nemours; and Nathan Kuppermann, emergency physician and clinical trialist, discuss the landmark PRoMPT BOLUS trial. They explore its global, pragmatic design, enrollment of 9,041 children, MAKE30 kidney outcomes, balanced fluids versus saline, guideline implications, Phoenix criteria, and forthcoming biomarker analyses.

Tanya Perry, cardiac intensivist and VAD program director specializing in pediatric mechanical circulatory support. She discusses device selection by size and diagnosis. She explains anticoagulation differences across devices and how networks harmonized protocols. She walks through stroke types on VADs, monitoring challenges, inflammatory contributors, and the ACTION network’s ABCs for stroke prevention.

Tanya Perry, cardiac intensivist and director of the VAD Program at Cohen Children’s Medical Center, blends PICU and pediatric cardiology expertise. She compares ECMO versus VAD and when to transition. She walks through types of VAD support, device options and cannulation strategies. She covers device selection by size/diagnosis, monitoring and procedural logistics for Impella and Berlin Heart.

Robert Pass, pediatric cardiologist and electrophysiology specialist at Mount Sinai, explores high-grade AV block in children. Topics include ECG recognition, underlying causes, escape rhythms, perfusion-based risk assessment, medication trials, and when to escalate to temporary pacing. He also discusses practical techniques, limitations, and safety considerations for transcutaneous and transvenous pacing.

Ryan Morgan, pediatric intensivist and resuscitation scientist focused on intra-arrest physiology. Catherine Ross, pediatric critical care physician researching peri‑arrest drug strategies. They debate epinephrine dosing and tailoring by diastolic BP. They discuss bolus versus infusion tactics, vasopressin as a salvage option, inhaled nitric oxide for high pulmonary pressures, and controversies around bicarbonate and calcium use in arrest.

Merritt Tuttle, pediatric intensivist and medical toxicologist, walks through calcium channel blocker crises with clinical clarity. She covers recognizing red flags like low-and-slow physiology and hyperglycemia. Practical triage tips, early calcium and pressors, high-dose insulin timing and monitoring, ECMO thresholds, and rescue therapies are discussed in concise, actionable terms.

Ayesha Zia, pediatric hematologist and thrombosis expert at UT Southwestern, discusses pediatric pulmonary embolism. She covers early warning signs in children. She explains limits of clinical rules and D-dimer, risk stratification, and the role of echo and CT. She describes multidisciplinary PERT teams, reperfusion choices, anticoagulation timing, ECMO use, and key ICU considerations.