Dr. Kristen Smith is the PICU medical director, critical care fellowship program director, and director of the nurse practitioner program at the University of Michigan C.S. Mott Children’s Hospital. She received her medical degree from the University of Toledo and completed her pediatric residency at Akron Children’s Hospital, followed by a critical care fellowship at Johns Hopkins. Dr. Smith’s research is focused on the long-term outcome of Pediatric Intensive Care Unit (PICU) survivors.

Dr. Carly Schmidt is a critical care fellow at the University of Michigan C.S. Mott Children’s Hospital. She received her medical degree from Case Western University and completed her pediatric residency at Brown University, where she also served as chief resident. Carly is interested in the intersection of the PICU and the community via transport medicine, advocacy, and outcomes.

Learning Objectives:

By the end of this podcast, listeners should be able to describe:

1. Neuroprotective measures that should be provided to all pediatric patients with severe traumatic brain injury (TBI).
2. An expert, guideline-directed approach to managing a child with increased intracranial pressure due to severe TBI.

Reference:
Kochanek PM, Tasker RC, Bell MJ, Adelson PD, Carney N, Vavilala MS, Selden NR, Bratton SL, Grant GA, Kissoon N, Reuter-Rice KE, Wainwright MS. Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies. Pediatr Crit Care Med. 2019 Mar;20(3):269-279.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:
Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Stuart Goldstein, MD is a Professor of Pediatrics at the University of Cincinnati, where he serves as the Clark D. West Endowed Chair. He is a practicing pediatric nephrologist at Cincinnati Children’s where he also is the Director for the Center for Acute Care Nephrology and the Medical Director for the Pheresis Service. Dr Goldstein is the Founder and Principal Investigator for the Prospective Pediatric Acute Kidney Injury Research Group and has evaluated novel urinary AKI biomarkers in the pediatric critical care setting.

Dr. Katherine Melink (at time of recording) is currently finishing her residency at Cincinnati Children's Hospital where she was able to conduct research in biomarkers for the prediction of kidney injury in critically ill children (particularly in the CICU). Her exposure to CRRT under physicians like Dr. Goldstein at Cincinnati Children's has served as a motivating factor to participate in this episode! She is excited to start PICU fellowship at Boston Children's Hospital in July.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

1. CRRT fundamentals, including how it differs from conventional hemodialysis and the rationale for its use in critically ill pediatric patients.
2. Key differences in ultrafiltration, diffusion, and convection and their clinical applications in CRRT.
3. Patient selection and indications for CRRT (AKI, fluid overload, toxic metabolite/ingestion among others)
4. Key evidence guiding use of CRRT in critically ill children.
5. Components of a CRRT prescription and guiding principles of how to titrate therapy.
6. Pitfalls and complications of CRRT
7. Common anticoagulation strategies in CRRT
8. General principles guiding liberation from CRRT.

Selected references:

Sutherland et al; ADQI 26 Workgroup. Epidemiology of acute kidney injury in children Pediatr Nephrol. 2024 Mar;39(3):919-928. doi: 10.1007/s00467-023-06164-w. Epub 2023 Oct 24.

Basu et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014 Mar;85(3):659-67. doi: 10.1038/ki.2013.349. Epub 2013 Sep 18. PMID: 24048379;

Fuhrman et al; ADQI 26 workgroup. A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children. Pediatr Nephrol. 2024 Mar;39(3):929-939. doi: 10.1007/s00467-023-06133-3. Epub

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:
Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Stuart Goldstein, MD is a Professor of Pediatrics at the University of Cincinnati, where he serves as the Clark D. West Endowed Chair. He is a practicing pediatric nephrologist at Cincinnati Children’s where he also is the Director for the Center for Acute Care Nephrology and the Medical Director for the Pheresis Service. Dr Goldstein is the Founder and Principal Investigator for the Prospective Pediatric Acute Kidney Injury Research Group and has evaluated novel urinary AKI biomarkers in the pediatric critical care setting.

Dr. Katherine Melink (at time of recording) is currently finishing her residency at Cincinnati Children's Hospital where she was able to conduct research in biomarkers for the prediction of kidney injury in critically ill children (particularly in the CICU). Her exposure to CRRT under physicians like Dr. Goldstein at Cincinnati Children's has served as a motivating factor to participate in this episode! She is excited to start PICU fellowship at Boston Children's Hospital in July.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

1. CRRT fundamentals, including how it differs from conventional hemodialysis and the rationale for its use in critically ill pediatric patients.
2. Key differences in ultrafiltration, diffusion, and convection and their clinical applications in CRRT.
3. Patient selection and indications for CRRT (AKI, fluid overload, toxic metabolite/ingestion among others)
4. Key evidence guiding use of CRRT in critically ill children.
5. Components of a CRRT prescription and guiding principles of how to titrate therapy.
6. Pitfalls and complications of CRRT
7. Common anticoagulation strategies in CRRT
8. General principles guiding liberation from CRRT.

Selected references:

Sutherland et al; ADQI 26 Workgroup. Epidemiology of acute kidney injury in children Pediatr Nephrol. 2024 Mar;39(3):919-928. doi: 10.1007/s00467-023-06164-w. Epub 2023 Oct 24.

Basu et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014 Mar;85(3):659-67. doi: 10.1038/ki.2013.349. Epub 2013 Sep 18. PMID: 24048379;

Fuhrman et al; ADQI 26 workgroup. A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children. Pediatr Nephrol. 2024 Mar;39(3):929-939. doi: 10.1007/s00467-023-06133-3. Epub

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:
Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.