Browsing by Subject "Pediatric critical care medicine"

Now showing 1 - 4 of 4
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    A Multimodal Educational Boot Camp for Training Fellows in Pediatric Extracorporeal Membrane Oxygenation (ECMO)
    (Association of American Medical Colleges, 2024-10-17) Park, Yujin; Hocutt, Gail; Wetzel, Elizabeth; Swinger, Nathan; Pearson, Kellie; Abulebda, Kamal; Gray, Brian; Surgery, School of Medicine
    Introduction: Pediatric extracorporeal membrane oxygenation (ECMO) management presents unique challenges in acute care settings, requiring specialized expertise to manage critically ill children. Medical and surgical fellows often manage these patients, but prior residency training rarely provides sufficient ECMO exposure. We developed and evaluated a multimodal pediatric ECMO boot camp for new fellows. Methods: This boot camp was implemented during 5-hour sessions in August 2021, August 2022, and August 2023. The curriculum included a 45-minute introductory didactics session, 30-minute hands-on circuit demonstration, and four 30-minute small-group activity stations. To assess knowledge acquisition, pre- and posttests were administered; participants also completed a post-boot camp survey to evaluate their confidence and provide feedback. Results: Forty-nine participants completed the boot camp, including 18 critical care, four cardiology, 11 pediatric surgery, 12 cardiothoracic surgery, and four pediatric emergency medicine fellows. Pre- and posttests demonstrated significant improvement in knowledge of ECMO circuit components and pressures (56% vs. 76%, p < .001). All of our participants agreed or strongly agreed that participating in the boot camp increased their confidence in troubleshooting ECMO emergencies. The inclusion of fellows from various clinical disciplines, offering a rich diversity of perspectives, was particularly valued by participants. Discussion: Our results demonstrate the feasibility and effectiveness of establishing a pediatric ECMO boot camp to train new surgical and medical fellows. The curriculum not only improved ECMO knowledge but also boosted learners' confidence in managing ECMO-related challenges.
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    High variability in cardiac education and experiences during United States paediatric critical care fellowships
    (Cambridge University Press, 2023) Hanson, Amy E.; Mastropietro, Christopher W.; Murphy, Lee D.; Rowan, Courtney M.; Pediatrics, School of Medicine
    Background: Paediatric cardiac critical care continues to become more sub-specialised, and many institutions have transitioned to dedicated cardiac ICUs. Literature regarding the effects of these changes on paediatric critical care medicine fellowship training is limited. Objective: To describe the current landscape of cardiac critical care education during paediatric critical care medicine fellowship in the United States and demonstrate its variability. Methods: A review of publicly available information in 2021 was completed. A supplemental REDCap survey focusing on cardiac ICU experiences during paediatric critical care medicine fellowships was e-mailed to all United States Accreditation Council of Graduate Medical Education-accredited paediatric critical care medicine fellowship programme coordinators/directors. Results are reported using inferential statistics. Results: Data from 71 paediatric critical care medicine fellowship programme websites and 41 leadership responses were included. Median fellow complement was 8 (interquartile range: 6, 12). The majority (76%, 31/41) of programmes had a designated cardiac ICU. Median percentage of paediatric critical care medicine attending physicians with cardiac training was 25% (interquartile range: 0%, 69%). Mandatory cardiac ICU time was 16 weeks (interquartile range: 13, 20) with variability in night coverage and number of other learners present. A minority of programmes (29%, 12/41) mandated other cardiac experiences. Median CHD surgical cases per year were 215 (interquartile range: 132, 338). When considering the number of annual cases per fellow, programmes with higher case volume were not always associated with the highest case number per fellow. Conclusions: There is a continued trend toward dedicated cardiac ICUs in the United States, with significant variability in cardiac training during paediatric critical care medicine fellowship. As the trend toward dedicated cardiac ICUs continues and practices become more standardised, so should the education.
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    The Neglected Price of Pediatric Acute Kidney Injury: Non-renal Implications
    (Frontiers Media, 2022-06-30) Pande, Chetna K.; Smith, Mallory B.; Soranno, Danielle E.; Gist, Katja M.; Fuhrman, Dana Y.; Dolan, Kristin; Conroy, Andrea L.; Akcan-Arikan, Ayse; Pediatrics, School of Medicine
    Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.
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    The Neglected Price of Pediatric Acute Kidney Injury: Non-renal Implications
    (Frontiers Media, 2022-06-30) Pande, Chetna K.; Smith, Mallory B.; Soranno, Danielle E.; Gist, Katja M.; Fuhrman, Dana Y.; Dolan, Kristin; Conroy, Andrea L.; Akcan-Arikan, Ayse; Pediatrics, School of Medicine
    Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.