Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. Dr. Kudchadkar is also the lead PI for the "PICU Up!" study, a 10-site randomized trial of a multifaceted early mobility program for critically ill children.In this episode, Dr. Kuchadkar shares her path from her general pediatrics residency at Hopkins to running a large multi-center trial as a dual-trained pediatric intensivist and anesthesiologist. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport 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. 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.

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.

In this engaging discussion, Dr. Kristina Betters, a pediatric intensivist at Vanderbilt University, and aspiring intensivist Dr. Brooke Light explore crucial aspects of ICU liberation for children. They delve into the A to F ICU liberation bundle, sharing insights on personalized sedation strategies and pain management. A powerful case study showcases the recovery of a young boy, emphasizing family involvement and evidence-based practices. They also address the critical role of nursing staff and multidisciplinary teams in enhancing patient care and safety.

Dr. Matthew Borgman, a Professor of Pediatrics specializing in Critical Care, shares his vast expertise in managing pediatric hemorrhagic shock. He delves into the complexities of recognizing and treating this condition, emphasizing careful fluid resuscitation and the strategic use of blood products. The discussion highlights the advantages of low titer group O whole blood and advanced coagulation testing methods like TEG and ROTEM. Borgman also addresses the challenges of implementing these practices in various healthcare settings, paving the way for improved trauma care.

Dr. Bill Bortcosh, a pediatric critical care expert, dives deep into the acid-base status evaluation essential for patient care. He discusses the practical application of the anion gap and how it serves as a vital screening tool. The conversation explores the nuances of fluid management, focusing on the effects of normal saline versus Plasmalite on chloride levels. Bortcosh also addresses the complexities of diagnosing metabolic acidosis, including renal tubular acidosis, emphasizing the importance of continuous learning in navigating these challenges.

Dr. Bill Bortcosh, a pediatric critical care expert and associate medical director of safety, shares insights into acid-base diagnosis in this engaging discussion. He emphasizes the importance of understanding acid-base status for acute care, illustrates this with a compelling case study, and explains the role of anion gap in diagnosis. Bortcosh also explores the emotional challenges in critical care and discusses his transition to pharmaceutical safety, shedding light on drug safety assessments and the complexities faced by healthcare providers.

In this discussion, Debra Regier, M.D., Ph.D., Chief of Genetics and Metabolism at Children's National Hospital, dives into the complexities of metabolic disorders. She explains how triglycerides convert to energy and the critical roles of carnitine and fatty acid oxidation. The podcast highlights the importance of recognizing unusual smells in diagnosing conditions like maple syrup urine disease. Dr. Regier also emphasizes the need for a collaborative approach in managing these disorders, particularly in pediatric care, addressing the unique challenges families face.

In this discussion, Dr. Debra Regier, Chief of Genetics and Metabolism at Children's National Hospital, shares her expertise on the complexities of inborn errors of metabolism. She emphasizes critical metabolic pathways vital for energy production and the nuances of newborn screening. The conversation then shifts to managing metabolic emergencies, focusing on lactate and ammonia levels. Additionally, Dr. Regier highlights specific disorders like PKU and GA1, outlining urgent care strategies and advancements in neonatal dialysis safety.

In this riveting discussion, Dr. Kristen Smith, the PICU medical director at the University of Michigan, and Dr. Carly Schmidt, a critical care fellow, delve into managing traumatic brain injuries in children. They cover crucial neuroprotective measures and how to adeptly handle increased intracranial pressure. Key insights include strategies for cerebral edema management, the challenges of existing treatments, and the importance of clear communication with families during recovery. Their expertise sheds light on hope, collaboration, and the evolving landscape of pediatric TBI care.