PedsCrit

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.

Dr. Nadir Yehya, an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine, discusses adjunctive strategies for treating ARDS, including corticosteroids, prone positioning, iNO, and surfactant. The podcast explores the benefits of these strategies in improving ventilation and oxygenation, and highlights the importance of weighing risks and potential benefits. Additionally, the use of nitric response, monitoring, and weaning protocol for ARDS patients is discussed, along with the use of surfactant and VV ECMO in ARDS management.

Dr. Nadir Yehya, an expert in pediatric respiratory failure, discusses non-conventional ventilation modes like APRV and oscillation in ARDS patients. The podcast explores the advantages and considerations of these modes, as well as their effectiveness and limitations. It also delves into treatment options for pediatric patients with refractory ERDS, including the use of the oscillator and potential ECMO cannulation.

Dr. Nadir Yehya, Assistant Professor of Anesthesiology and Critical Care and Pediatrics, discusses selecting initial PEEP and measuring variables for optimal PEEP. The chapter explores different strategies for setting PEEP in pediatric and adult patients. It also discusses the measurement of plateau pressure in pediatric mechanical ventilation and the use of esophageal pressure monitors to titrate ventilation support. Additionally, it explores how sedation levels can affect thoracic pressure in intubated patients.

Dr. Nadir Yehya, a pediatric critical care specialist, discusses the use of non-invasive ventilation in capturing kids with developing ARDS early and challenges in designing trials for pediatric ARDS research. The podcast explores the use and effectiveness of high flow nasal cannula in clearing dead space in the respiratory system. It also discusses the relationship between head size and babies' breathing, mechanisms and benefits of high flow ventilation, and situations where high flow may be tried even if intubation is not desired.

Dr. Melinda Cory, Assistant Professor of Pediatrics at UT Southwestern Medical Center, discusses atrioventricular septal defects (AVSDs) and their management. Topics covered include the decision to become double-boarded in cardiology and critical care, AVSD classification and terminology, post-operative management for children with trisomy 21 and AVSDs, timing of excavation and barriers to discharge in cardiac ICU patients, and monitoring complications for children with AVSDs.

Two expert pulmonologists discuss the intricate decision-making process surrounding tracheostomies in children. They delve into the essential support systems for families transitioning from hospital to home care. Topics include oxygen management, the pivotal role of respiratory therapists, and the necessity of emergency preparedness. They also highlight valuable resources designed to assist families, emphasizing personalized care and effective communication in navigating these challenging circumstances.