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Category: Pediatrics

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SCCM Pod-319 Learning from Others: What We Can All Take from the Pediatrics Experience

Margaret Parker, MD, MCCM, speaks with Neethi Pinto, MD, about her talk, “Learning from Others: What We Can All Take from the Pediatrics Experience,” presented at the 45th Critical Care Congress in Orlando, Florida. This talk is part of the session, “THRIVE: Supporting Survivors After Critical Illness.” THRIVE is a new initiative from the Society of Critical Care Medicine that aims to connect patient and family ICU survivors and raise awareness of post-intensive care syndrome.


SCCM Pod-258 Extubation During Pediatric ECMO: A Single-Center Experience

Margaret Parker, MD, MCCM, speaks with James Thomas, MD, about the article, “Extubation During Pediatric Extracorporeal Membrane Oxygenation: A Single-Center Experience,” published in Pediatric Critical Care Medicine. Dr. Thomas is a Professor of Pediatric Critical Care Medicine in the Department of Pediatrics at the Baylor College of Medicine in Houston, Texas and the Medical Director of their ECMO program. In this article, Dr. Thomas and coauthors compare the prevalence, resource utilization, and mortality for pediatric severe sepsis identified using two established identification strategies.


SCCM Pod-165 PCCM: PAI-1 May Lead to Early Diagnosis of VAP in Children

Ramya Srinivasan, MD, discusses her article published in the January Pediatric Critical Care Medicine titled, “Plasminogen Activation Inhibitor Concentrations in Bronchoalveolar Lavage Fluid Distinguishes Ventilator-Associated Pneumonia from Colonization in Mechanically Ventilated Pediatric Patients.” The article found that PAI-1 discriminated well between pediatric patients diagnosed clinically with VAP compared with those who were considered colonized. This resulted in PAI-1 being useful in directing appropriate antibiotic therapy in intubated patients suspected of having a new pulmonary infection. Srinivasan is a pediatric intensivist at Sutter Memorial Hospital in Sacramento and a translational researcher at the University of California in San Francisco.


PANDEM Guidelines for Infants and Children  

Ped Crit Care Med 2022 Feb;23(2):e74-e110


SCCM Pod-448 Noninvasive Respiratory Support: Opinion- or Evidence-Based Medicine?

When should clinicians intubate preterm infants? The answer is not always straightforward, according to podcast guest Deepak Jain, MD, FAAP. He and host Pamela M. Peeke, MD, MPH, FACP, FACSM, discuss strategies that optimize noninvasive ventilation and when such strategies are appropriate, referring to a 2015 JAMA article (Stoll BJ et al. JAMA. 2015;314:1039-1051). Dr. Jain is interim chief in the Division of Neonatology at Rutgers Robert Wood Johnson Medical School. This podcast is supported by an unrestricted education grant from Medtronic.


SCCM Pod-431 Hypertonic Saline in Children with Raised Intracranial Pressure

Mannitol is a commonly used osmotherapy agent in raised intracranial pressure (ICP) but the side effects are significant. An alternative therapy, hypertonic saline, has shown varied results. Host Margaret M. Parker, MD, MCCM, is joined by Arun Bansal, MD, to review a study that compared the effect of hypertonic saline versus mannitol on raised ICP in pediatric acute central nervous system infections (Rameshkumar R, et al. Pediatr Crit Care Med. 2020 Dec;21:1071-1080). Dr. Bansal is a professor in the department of pediatrics at the Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research in Chandigarh, India.


SCCM Pod-425 Outcomes in Cystic Fibrosis PICU Admissions

Cystic fibrosis patient care has advanced greatly in recent years and the mortality rate has improved. Host Margaret M. Parker, MD, MCCM, talks with Michael A. Smith, MD, about PICU mortality and the factors associated with death among critically ill children with cystic fibrosis (Smith M, et al. Pediatr Crit Care Med. 2020 Oct;21:e879-887). Dr. Smith is in a pediatric critical care medicine fellow in the department of pediatric critical care medicine at the University of California, San Francisco in San Francisco, California, USA.


SCCM Pod-412 COVID-19 in Critically Ill Children

Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider (Ong J, et al. Pediatr Crit Care Med. 2020 Apr 7; Epub ahead of print) with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH.

Preparedness activities that every pediatric ICU should perform are also explored. Dr. Ong is head of the paediatric ICU at National University Hospital in Singapore.


SCCM Pod-407 Life Following Pediatric Septic Shock

Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM, talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock.

This discussion is based on two articles Dr. Zimmerman recently published in Critical Care MedicineCritical Illness Factors Associated With Long-Term Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock (Zimmerman J, et al. Crit Care Med. 2020;48(3):319-328) and Trajectory of Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock (Zimmerman J, et al. Crit Care Med. 2020;48(3):329-337).

Dr. Zimmerman is professor of pediatrics and anesthesiology and a faculty member and emeritus division chief of pediatric critical care medicine at Seattle Children's Hospital, Harborview Medical Center, and University of Washington School of Medicine in Seattle, Washington, USA. He has received research funding from National Institutes of Health, Immunexpress, and Seattle Children’s Research Institute, royalties from Elsevier Publishing as co-editor for Pediatric Critical Care, and travel reimbursement from SCCM.


SCCM Pod-399 Risk for Mortality in Critically Ill Children Needing Renal Replacement Therapy

Margaret M. Parker, MD, MCCM, speaks with Danny Hames, MD, on his article titled "Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy," published in the November 2019 issue of Pediatric Critical Care Medicine (Hames D, et al. Pediatr Crit Care Med. 2019;20;1069-1077).

Dr. Hames speaks about some of the challenges of monitoring patients with acute kidney injury, the implications of the study for pediatric intensivists, the importance of being mindful of renal function and fluid balance for ventilated patients, and areas that need further investigation.

Dr. Hames is an attending physician in the Division of Cardiovascular Critical Care in the Department of Cardiology at Boston Children’s Hospital and an instructor in the Department of Pediatrics at Harvard Medical School in Boston, Massachusetts, USA.


SCCM Pod-394 Polyneuropathy in Critically Ill Mechanically Ventilated Children

Margaret M. Parker, MD, MCCM, speaks with Rakesh Lodha, MD, on his article titled Polyneuropathy in Critically Ill Mechanically Ventilated Children: Experience from Tertiary Care Hospital in North India, published the September issue of Pediatric Critical Care Medicine (Shubham S, et al. Pediatr Crit Care Med. 2019;20:826-831).

The authors review the methodology, primary findings, and limitations of the study, as well as implications to the clinician at the bedside and pressing research issues.

Dr. Lodha is a professor at All India Institute of Medical Sciences in New Delhi, India. This podcast is sponsored by Sound Critical Care.


SCCM Pod-393 Updated Pediatric Admission, Discharge, and Triage and Levels of Care Guidance

Margaret M. Parker, MD, MCCM, and Lorry R. Frankel, MD, FCCM, discuss the updated pediatric critical care admission, discharge, and triage criteria and levels of care guidance published in the September issue of Pediatric Critical Care Medicine (Frankel L, et al. Pediatr Crit Care Med. 2019;20:847-887).

They review the methodology behind the development of this joint Society of Critical Care Medicine and American Academy of Pediatrics updated guidance, the areas of agreement, and what we may see in future updates.

Dr. Frankel is chair of the Department of Pediatrics at California Pacific Medical Center and emeritus professor of pediatrics at Stanford University School of Medicine in Stanford, California, USA.


SCCM Pod-391 Pediatric Nutritional Guidelines

Margaret M. Parker, MD, MCCM, and Elizabeth Emrath, MD, discuss Dr. Emrath’s talk on the new pediatric nutritional guidelines (Mehta N, et al. Pediatr. Crit Care Med. 2017;18:675-715) from the 48th Critical Care Congress precourse Current Concepts in Pediatric Critical Care.

They review the updated recommendations and what future research is needed. Dr. Emrath is an assistant professor at the Medical University of South Carolina in Charleston, South Carolina, USA.

This podcast is sponsored by Nestle Health Science.


SCCM Pod-389 Infections on Extracorporeal Life Support

Margaret M. Parker, MD, MCCM, and Luregn Schlapbach, MD, FCICM, review a survey of international practice on prevention, diagnosis, and treatment of infections on extracorporeal life support in adults and children published in Pediatric Critical Care Medicine (Farrell, Deborah, et al. Pediatr Crit Care Med. 2019;20:667-671).

Dr. Schlapbach is a pediatric intensivist at Queensland Children's Hospital in South Brisbane, Australia.


SCCM Pod-384 Updated Pediatric Severe Traumatic Brain Injury Guidelines

Margaret M. Parker, MD, MCCM, and Patrick M. Kochanek, MD, MCCM, discuss the updated pediatric severe traumatic brain injury guidelines (Kochanek P, et al. Pediatr Crit Care Med. 2019;20:S1-S82).

They review what is new in the third edition of the guidelines and what further research can be done.

Dr. Kochanek is director of the Safar Center for Resuscitation Research at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania, USA.

This podcast is sponsored by Philips and Masimo.


SCCM Pod-372 Nutrition Support Therapy in the Pediatric Critically Ill Patient

Margaret Parker, MD, MCCM, speaks with Nilesh M. Mehta, MD, about the article, “Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition,” published in the July 2017 issue of Pediatric Critical Care Medicine. Dr. Mehta discusses best practices in nutrition therapy in critically ill children.

Dr. Mehta is the Director of Critical Care Nutrition in the division of critical care medicine in the department of anesthesiology, critical care, and pain medicine at Boston Children’s Hospital and an associate professor of anesthesia (critical care) at Harvard Medical School in Boston, Massachusetts.

Mehta, Nilesh M. MD; Skillman, Heather E. MS, RD, CSP, CNSC; Irving, Sharon Y. PhD, CRNP, FCCM, FAAN; Coss-Bu, Jorge A. MD; Vermilyea, Sarah MS, RD, CSP, LD, CNSC; Farrington, Elizabeth Anne PharmD, FCCP, FCCM, FPPAG, BCPS; McKeever, Liam MS, RDN; Hall, Amber M. MS; Goday, Praveen S. MBBS, CNSC; Braunschweig, Carol PhD, RD. Ped Crit Care Med. 2017; 18(7):675-715.

This podcast is supported by an educational grant provided from Abbott Nutrition.


SCCM Pod-367 Variability in Antibiotic Use Across PICUs

Margaret Parker, MD, MCCM, speaks with Thomas V. Brogan, MD, about the article “Variability in Antibiotic Use Across PICUs,” published in the June 2018 issue of Pediatric Critical Care Medicine. Dr. Brogan discusses study findings regarding the variation in antibiotic use in pediatric intensive care units (PICUs) across institutions. He considers how overuse or inappropriate use can be addressed in PICUs in the future. Dr. Brogan is a Professor of Pediatrics in the Division of Pediatric Critical Care Medicine at the Seattle Children’s Hospital and the University Washington School of Medicine in Seattle, Washington. Ped Crit Care Med. 2018; 19(6):519-527. Released: 7/26/18


SCCM Pod-363 Hemodynamic Support of Pediatric and Neonatal Septic Shock

Margaret Parker, MD, MCCM, speaks with Joseph A. Carcillo, MD, about the article, "American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock," published in the June 2017 issue of Critical Care Medicine. Dr. Carcillo the revisions made to the 2014 guidelines and recommendations regarding use of 1) a “recognition bundle” containing a trigger tool for rapid identification of patients with septic shock, 2) a “resuscitation and stabilization bundle” to help adherence to best practice principles, and 3) a “performance bundle” to identify and overcome perceived barriers to the pursuit of best practice principles. Dr. Carcillo is a professor of Anesthesia, Critical Care Medicine, and Pediatrics at the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania. Crit Care Med. 2017; 45(6):1061-1093. Published: 6/7/2018


SCCM Pod-362 Time of Admission to the PICU and Mortality

Margaret Parker, MD, MCCM, speaks with Michael C. McCrory, MD, MS, about the article, “Time of Admission to the PICU and Mortality,” published in the October 2017 issue of Pediatric Critical Care Medicine. Dr. McCrory discusses research findings examining how admissions and discharges to the pediatric intensive care unit (PICU) vary throughout the day and whether off-hours admissions or other factors lead to a higher rate of mortality in the PICU. Dr. McCrory is an associate professor and pediatric intensive care attending in the Department of Anesthesiology in the Section of Pediatric Critical Care Medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina. Ped Crit Care Med. 2017; 18(10):915-923. Published: 4/3/2018


SCCM Pod-348 Delirium in Critically Ill Children

Margaret Parker, MD, MCCM, speaks with Chani Traube, MD, about the article, “Delirium in Critically Ill Children: An International Point Prevalence Study,” published in the April 2017 issue of Critical Care Medicine. Dr. Traube discusses the complexity of diagnosing pediatric delirium in pediatric intensive care unit (PICU) patients. Study findings showed that one out of every four children in the PICU was delirious, with hypoactive delirium being most common. Dr. Traube is an Associate Professor of Pediatrics at Weill Cornell Medical College in New York where she works as a PICU attending and clinical researcher. Crit Care Med. 2017; 45(4):584-590. Released: 8/29/17