SCCM Podcast

Pediatric advanced life support (PALS) guidelines include weight-based epinephrine dosing recommendations of 0.01 mg/kg with a maximum of 1 mg, which corresponds to a weight of 100 kg. But what are the actual practice patterns? Elizabeth H. Mack, MD, MS, FCCM, is joined by Martha Kienzle, MD, to discuss the article: Weight-Based Versus Flat Dosing of Epinephrine During Cardiac Arrest in the PICU: A Multicenter Survey, published in the October 2022 issue of Pediatric Critical Care Medicine. Dr. Kienzle is an attending physician in the Department of Anesthesiology and Critical Care Medicine at Children's Hospital of Philadelphia.

The American Heart Association's (AHA) cardiopulmonary resuscitation guidelines recommend against the routine administration of IV calcium during pediatric cardiopulmonary arrest because of its association with worse outcomes. However, IV calcium is routinely used in children with heart disease who have cardiopulmonary arrest. Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Gurpreet S. Dhillon, MD, to discuss the article, Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease is Associated With Worse Survival - A Report From the American Heart Association's Get With the Guidelines-Resuscitation (GWTG-R) Registry, published in the November issue of Pediatric Critical Care Medicine (Dhillon G, et al. Pediatr Crit Care Med. 2022;23:860-871). Dr. Dhillon is a pediatric cardiac intensivist at Lucile Packard Children's Hospital at Stanford in Palo Alto, California.

Untreated hyperammonemia can cause irreversible neurologic damage, coma, or death. A high level of clinical suspicion is necessary to quickly recognize and implement emergency interventions for hyperammonemia in the acute presentation of urea cycle disorders (UCDs). Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Anna-Kaisa Niemi, MD, PhD, and a patient who was hospitalized for hyperammonemia at age 8 years to discuss the importance of improved recognition of hyperammonemia and awareness of the underlying causes, such as UCDs. Dr. Niemi is a neonatologist and associate professor at Rady Children’s Hospital in San Diego, California, USA. This podcast is sponsored by Horizon Therapeutics.

Are there bullies in the world of advanced practice providers (APPs)? How is bullying defined in a clinical environment? In this podcast, hosted by Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, three APPs from different hospitals debate incivility and workplace culture. They also address interpersonal relationships among APPs, physicians, and nurses.

Unrecognized clinical deterioration during illness requiring hospitalization is associated with high risk of mortality and long-term morbidity among children. In this podcast hosted by Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, Anoop Mayampurath, PhD, discusses a novel machine learning model that identifies ICU transfers in hospitalized children more accurately than current tools.

Nosocomial infections are a prevalent cause of death and complications in critically ill children. Conventional cultures are able to detect only up to 25% of bacteremias. Several studies have suggested that molecular tests could be a faster and effective tool for detection of bacterial infections.

This podcast will educate clinicians on the unfamiliar parameters of processed EEG (pEEG). Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Meghan B. Lane-Fall, MD, MSHP, FCCM, to discuss the benefits of pEEG for monitoring sedated mechanically ventilated patients and patients undergoing neuromuscular blockade. Dr. Lane-Fall is an associate professor of anesthesiology, critical care, and epidemiology at the University of Pennsylvania. This podcast is sponsored by Medtronic.

Catecholamine is used in patients with septic shock to augment hemodynamics and achieve goal mean arterial pressure. Ludwig H. Lin, MD, is joined by Gretchen L. Sacha BCCCP, PharmD, to discuss this retrospective observational study to evaluate the associations of catecholamine dose, lactate concentration, and timing from shock onset at vasopressin initiation with in-hospital mortality. (Sacha G, et al. Crit Care Med. 2022;50:614-623). Dr. Sacha is a critical care clinical specialist at Cleveland Clinic in Cleveland, Ohio. This podcast is sponsored by Sound Physicians.

While little is known about the epidemiology of ventilator-acquired pneumonia among COVID-19 patients, some studies suggest a higher risk of ventilator-associated pneumonia in this specific population. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Charles-Herve Vacheron, MD, to discuss the Cohort exposed/nonexposed study among the REA-REZO surveillance network.

This podcast will examine a retrospective, observational cohort study that found an association between excessive oxygen supplementation in the first day of mechanical ventilation with multiple organ dysfunction syndrome on day 7 of admission and in-hospital mortality in critically ill children. Host Elizabeth H. Mack, MD, MS, FCCM, is joined by L. Nelson Sanchez-Pinto, MD, MBI, to discuss the study's findings.