PedsCrit

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.

In this engaging discussion, Dr. Kristen Smith, 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 share insights on neuroprotective measures essential for severe TBIs and the complexity of critical care management. Topics include optimizing oxygen delivery and personalized sedation strategies, emphasizing the importance of monitoring and adapting treatment to improve outcomes for young patients.

Dr. Stuart Goldstein, a pediatric nephrologist and director at Cincinnati Children's, joins the conversation along with Dr. Katherine Melink, a resident engaged in kidney injury research. They delve into the fundamentals of Continuous Renal Replacement Therapy (CRRT) and its advantages over conventional dialysis for critically ill children. Highlighted are innovative anticoagulation strategies, advancements in filter technology, and the vital role of biomarkers in patient assessment. Collaboration in pediatric care emerges as a key theme in effectively managing acute kidney injury.

Dr. Stuart Goldstein, a pediatric nephrologist and professor at the University of Cincinnati, joins the discussion alongside Dr. Katherine Melink, a future PICU fellow. They delve into the fundamentals of Continuous Renal Replacement Therapy (CRRT) and its critical role in treating acute kidney injury in children. The conversation covers the evolution of terminology from 'acute renal failure' to 'acute kidney injury,' the rationale for CRRT, and the significance of biomarkers like N-GAL for optimal patient care.