PedsCrit

Join Dr. Brian Bridges, Division Chief of Pediatric Critical Care Medicine, and Dr. Abhinav Totapally, pediatric intensivist, as they delve into the complexities of VA ECMO for refractory septic shock in children. They discuss the pros and cons of central versus peripheral cannulation, sharing personal experiences and insights on patient selection. The talk explores advancements in ECMO, emphasizing the impact of early intervention on outcomes, monitoring techniques, and the need for multidisciplinary care to tackle this critical condition effectively.

Delve into the world of VA ECMO for children facing refractory septic shock. Hear expert insights on timely interventions and the complexities of patient management. Discover critical indicators for selecting candidates for ECMO and the importance of hemodynamic assessments. The discussion highlights the balance between flow rates and outcomes, along with approaches to optimize care. Personal stories enrich the exploration of mentorship and innovation in pediatric critical care, emphasizing collaboration for better patient outcomes.

Ilyse Genser, a pediatric neurologist and associate program director at Children's National Hospital, delves into the fascinating world of neuroimaging for critically ill children. She discusses the vital role of MRI with contrast in diagnosing conditions like encephalitis and the nuances of using FLAIR sequences for post-infectious disorders. Ilyse also tackles diagnosis challenges in pediatric mastoiditis, highlighting innovative imaging strategies, and wraps up with her favorite ice cream spots, blending medical insights with a dash of fun.

In this insightful discussion, Dr. Ilyse Genser, a pediatric neurologist and associate program director at Children's National Hospital, dives into the intricacies of neuroimaging for critically ill children. She shares essential insights on using head ultrasounds and CT scans, underlining the balance between diagnostic benefits and radiation concerns. Dr. Genser explains the urgent protocols for assessing pediatric strokes and highlights the importance of timely imaging. Her expert guidance equips pediatric intensivists with practical strategies for navigating complex cases.

Dr. Philip C. Spinella, a leading professor and trauma expert at the University of Pittsburgh, discusses groundbreaking advancements in blood product resuscitation. He highlights the shift to whole blood use over crystalloids for better survival rates in hemorrhagic shock. The episode delves into the complexities of citrate management in transfusions and the evolution of platelet storage practices. Spinella also explores the importance of localized approaches in pediatric care, concluding with an unexpected culinary diversion featuring a delicious meatball recipe.

Dr. Philip Spinella, a professor and director at the University of Pittsburgh's Trauma and Transfusion Medicine Research Center, shares insights from his unique journey from pediatrician to battalion surgeon. He discusses transformative blood transfusion practices, including the importance of whole blood in pediatric care and the establishment of 'walking blood banks.' Spinella highlights the necessity of bending rules in high-pressure medical environments to foster innovation and save lives, while also exploring advancements in managing severe hemorrhage.

Dr. Emily Olson, a fellow in pulmonary and critical care medicine, and Dr. Lekshmi Santhosh, an Associate Professor at UCSF, tackle the pressing issue of gender disparities in medical training. They share their personal journeys in medicine and discuss how gender impacts procedural opportunities for residents. Insights into implicit bias, the importance of mentorship, and strategies to foster equity in training are explored. They emphasize the need for a safe space to facilitate open discussions and enhance career progression for underrepresented groups.

Dr. Sapna Kudchadkar, Anesthesiologist-in-Chief of Johns Hopkins Children's Center, shares her remarkable journey from general pediatrics to leading groundbreaking research in pediatric critical care. She emphasizes the importance of mentorship and collaboration in building a successful research career. Dr. Kudchadkar discusses her innovative 'PICU Up!' intervention, highlighting how unexpected opportunities can reshape one's path. Her anecdotes reveal a passion for improving outcomes for critically ill children through early mobility strategies and rehabilitation.

Dr. Sapna Kudchadkar, Anesthesiologist-in-Chief at Johns Hopkins Children's Center, discusses innovative sedation strategies for critically ill children. She shares techniques to reduce delirium risks and the importance of effective pain management. Listeners learn about optimizing sedation practices, prioritizing 'therapeutic cuddles' for early mobility, and the human element of care. Dr. Kudchadkar emphasizes teamwork, tailored approaches, and family involvement in recovery, all aimed at enhancing outcomes in pediatric critical care.

Dr. Kristina Betters, a pediatric intensivist and delirium researcher at Vanderbilt University, joins aspiring intensivist Dr. Brooke Light to discuss vital topics in pediatric critical care. They delve into the challenges of diagnosing delirium in young patients, highlighting the importance of screening tools. The duo advocates for early mobility interventions tailored to developmental needs and emphasizes family involvement in the ICU to enhance recovery. Their insights on implementing ICU bundles reveal how even partial strategies can lead to improved outcomes.