Guest Jenna Miller, Associate Professor of Pediatrics, discusses troubleshooting the VV-ECMO circuit and preparing for early rehab. Topics include nutrition for patients on VV-ECMO, moving towards early extubation and mobilization, breastfeeding and feeding on ECMO, waking up patients on ECMO, and early rehabilitation and sedation approach for pediatric patients.

Jenna Miller, MD and Dr John Daniel discuss the different cannulas used in VV ECMO, the importance of proper cannula placement, and the risks associated with movement. They also explore the benefits of lung rest and extubation strategy for respiratory kids on ECMO, along with important aspects such as neurosedation, bottle feeding, and monitoring cannula placement.

Experts discuss their personal experiences and advice in the field of ECMO. The use of VV ECMO in respiratory failure and the criteria for cannulation are explored. Choosing between VV and VA ECMO for progressive respiratory failure is discussed, along with the benefits of VV ECMO in neonates.

Dr. Scott Weiss, an Associate Professor of Pediatrics and Pathology, discusses the use of vasoactive agents and monitoring of hemoglobin and lactate values in the treatment of septic shock. He explores the choice of vasoactive agents for children with septic shock and highlights the differences between pediatric and adult practice. He emphasizes the importance of reassessing non-responsive septic shock patients, identifying common dynamics of sepsis, and improving the management of children with septic shock.

Dr. Scott Weiss, Associate Professor of Pediatrics and Pathology at Thomas Jefferson University and Chair of the Division of Pediatric Critical Care Medicine at Nemours Children’s Hospital, discusses fluid bolus therapy and accurate measurement of capillary refill in septic shock. The podcast also covers differentiating between warm and cold shock in pediatric sepsis, the importance of physical examination, and additional monitoring techniques used in ICU management.

Dr. Sam Davila, a specialist in pediatric infectious diseases and cardiac critical care, discusses ventilator-associated pneumonia. He explores the diagnosis and treatment of VAP, considerations for empiric therapy, and strategies for preventing and managing VAP.

Dr. Karen Fauman, an associate professor of Pediatrics at the University of Chicago and dual boarded pediatric intensivist and palliative care physician, discusses the pathophysiology of oxygen delivery, indications for VV and VA ECMO, interpreting flow and RPM measurements, assessing lung recovery through air bronchograms, and the process of weaning a patient from ECMO with the Cribsiders.

Dr. Karen Fauman, an Associate Professor of Pediatrics and ECMO enthusiast, discusses ECMO essentials with the Cribsiders in this podcast. They cover topics such as the basic pathophysiology of oxygen delivery, indications for VV and VA ECMO, the sequence of the ECMO circuit, and signs that a patient may be ready to be liberated from ECMO.

Dr. Mekela Whyte-Nesfield, a Critical Care attending at Children’s National Hospital, discusses strategies for managing mechanical ventilation in patients with asthma. Topics covered include evaluation and adjustment of plateau pressure and peak pressure settings, benefits and risks of paralyzing intubated asthmatic patients, criteria for considering ECMO, and considerations for mechanical ventilation and extubation in status asthmaticus.

Dr. Mekela Whyte-Nesfield, a Critical Care attending at Children's National Hospital, discusses indications for intubation in asthma patients, acid-base abnormalities, sedation and paralysis considerations, medications and techniques for treatment, and the challenges of manual chest compression in asthmatic patients.