OPENPediatrics OPENPediatrics

In this World Shared Practice Forum podcast, Drs. Sapna Kudchadkar and Kate Madden discuss early mobilization programs in pediatric intensive care units (PICUs). They highlight the importance of interdisciplinary collaboration, including the need for shared mental frameworks regarding sedation practices and delirium screening and management. Dr. Kudchadkar describes the potential risks of delirium, the benefits of keeping patients oriented and engaged, and highlights the need for sustainability of early mobilization. She also discusses the implementation and challenges of the PICU UP! program.

LEARNING OBJECTIVES
Following this discussion, learners will be able to:
- Discuss the importance of early mobilization in PICU
- Explain the risks of delirium, as well as appropriate screening and management
- Identify the origins, goals, and benefits of the PICU Up! program

AUTHORS
Sapna Kudchadkar, MD, PhD, FCCM
Professor, Anesthesiologist-in-Chief of Johns Hopkins Children's Center, Vice Chair for Pediatric Anesthesiology and Critical Care Medicine, Director of the John Hopkins PICU Up! Program
Johns Hopkins University School of Medicine

Kate Madden, MD
Senior Associate, BCH Medical-Surgical ICU
Boston Children's Hospital
Assistant Professor of Anesthesiology
Harvard Medical School

DATE
Initial publication date: May 24, 2024.

ARTICLES REFERENCED
00:04:43 Wieczorek B, Ascenzi J, Kim Y, et al. PICU Up!: Impact of a Quality Improvement Intervention to Promote Early Mobilization in Critically Ill Children. Pediatr Crit Care Med. 2016;17(12):e559-e566. doi:10.1097/PCC.0000000000000983 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5138131/)

00:06:32 Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017;33(2):225-243. doi:10.1016/j.ccc.2016.12.005 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351776)

00:06:37 ICU liberation initiative (https://www.sccm.org/iculiberation)

00:33:24 Lin JC, Srivastava A, Malone S, et al. Caring for Critically Ill Children With the ICU Liberation Bundle (ABCDEF): Results of the Pediatric Collaborative. Pediatr Crit Care Med. 2023;24(8):636-651. doi:10.1097/PCC.0000000000003262 (https://pubmed.ncbi.nlm.nih.gov/37125798/)

00:34:32 Kudchadkar SR, Nelliot A, Awojoodu R, et al. Physical Rehabilitation in Critically Ill Children: A Multicenter Point Prevalence Study in the United States. Crit Care Med. 2020;48(5):634-644. doi:10.1097/CCM.0000000000004291 (https://pubmed.ncbi.nlm.nih.gov/32168030/)

00:39:40 X @SapnaKMD (https://x.com/sapnakmd)

Please visit: http://www.openpediatrics.org

OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

Kudchadkar SR, O’Hara JE, Madden K. PICU Up!: Collaboration for Success by S. Kudchadkar | OPENPediatrics. 05/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/picu-up-collaboration-for-success-by-s-kudchadkar-openpediatrics

In this special Complex Care Journal Club podcast episode, co-hosts Kristie Malik, Emily Goodwin and Kathleen Huth interview presenters of posters and oral abstracts relevant to the care of children with medical complexity at the Pediatric Academic Societies (PAS) 2024 annual meeting. Speakers describe the implications of their study findings, messages for patients and families, and priority areas for research that they hope can be investigated further by the complex care community in the coming years.

SPEAKERS
Mary Arakelyan, MPH
Research Project Manager
Dartmouth Health Children's

Tammie Dewan, MD, MSc
Clinical Assistant Professor
Department of Pediatrics, University of Calgary
Pediatrician, Alberta Children's Hospital

Caleb Easterly, BA
MD/PhD Student
University of North Carolina School of Medicine

Kevin Huynh, MS
Medical Student
University of Pittsburgh School of Medicine

Ruchi Kaushik, MD, MEd, MPH
Medical Director of Education and Research
Imagine Pediatrics, Houston TX

Joanna Leyenaar, MD, PhD
Professor, Department of Pediatrics
Dartmouth Health Children's

Savithri Nageswaran, MD, MPH
Professor, Department of Pediatrics
Wake Forest University School of Medicine

Julia Reedy, MA
Qualitative Analyst
ACCORDS, University of Colorado

S. Margaret Wright, MD, MPH
Clinical Assistant Professor of Pediatrics
University of Missouri-Kansas City School of Medicine

Justin Yu, MD, MS
Assistant Professor of Pediatrics
UPMC Children’s Hospital of Pittsburgh

HOSTS
Kristina Malik, MD
Pediatrician, Special Care Clinic,
Children's Hospital Colorado

Emily J Goodwin, MD
Pediatrician, General Academic Pediatrics Beacon Program
Children’s Mercy Kansas City

Kathleen Huth, MD, MMSc
Pediatrician, Complex Care Service, Division of General Pediatrics
Boston Children's Hospital

DATE
Initial publication: May 15, 2024.

REFERENCES
Fehlings D, Agnew B, Gimeno H, Harvey A, Himmelmann K, Lin JP, Mink JW, Monbaliu E, Rice J, Bohn E, Falck-Ytter Y. Pharmacological and neurosurgical management of cerebral palsy and dystonia: Clinical practice guideline update. Dev Med Child Neurol. 2024 Apr 19. doi: 10.1111/dmcn.15921. Epub ahead of print. PMID: 38640091.

Pediatric Academic Societies. Who we are. Accessed May 6, 2024. https://www.pas-meeting.org/about/

TRANSCRIPT


Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: forms.gle/Bdxb86Sw5qq1uFhW6

Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Malik K, Goodwin EJ, Arakelyan M, Dewan T, Easterly C, Huynh K, Kaushik R, Leyenaar J, Nageswaran S, Reedy J, Wright SM, Yu J, Huth K. Practice-Changing Research in Complex Care at the Pediatric Academic Societies 2024 Annual Meeting. 5/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/practice-changing-research-in-complex-care-at-the-pediatric-academic-societies-2024-annual-meeting

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients.

This episode is centered around the G Element of the Liberation bundle: Good Nutrition.

GUEST
Lynne Latten, BSc, RD
Paediatric Intensive Care Dietitian
Alder Hey Children's Hospital
Liverpool, England

HOST
Lyvonne Tume, RN, B Nurs, MSc Clinical Nursing (Crit Care) PGDE, PhD
Professor of Critical Care Nursing
Edge Hill University
Ormskirk, England, United Kingdom

DATES
Initial Publication date: May 10, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients.

This episode is centered around the F Element: Family Engagement and Empowerment.

GUEST
Lorena Acevedo, MD
Pediatric Intensivist
Fundación CardioInfantil
Bogota, Colombia

Elis de Pellegrin Rossi, MA
Hospital Clinical Psychologist
Hospital de Clinicas de Porto Alegre
Porto Alegre, Brazil

HOST
Cintia Johnston, Pt MsC PhD Post-doctor
Advisor Professor, Postgraduate Program, Department of Pediatrics
Faculty of Medicine of the University of São Paulo (FMUSP) – Brazil.


DATES
Initial Publication date: May 9, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients.

This episode is centered around the E Element: Early Mobility and Exercise.

GUESTS
Joel Lim Kian Boon, MBBS, MRCPCH, MMED
Consultant, Clinical Assistant Professor
Children's Intensive Care Unit, KK Women's and Children's Hospital
Singapore

Yang Liying, MSc
Senior Physiotherapist
KK Women's and Children's Hospital
Singapore

HOST
Qalab Abbas, MBBS, FCCM
Associate Professor
Aga Khan University
Karachi, Pakistan

DATES
Initial Publication date: May 8, 2024

World PICU Awareness Week '24 aims to shine a spotlight on the tireless efforts and innovative practices implemented in the PICU, aiming for better patient outcomes and enhanced quality of life. This series of podcasts focuses on the multifaceted nature of the ICU Liberation Bundle, understanding the importance of pain control, optimizing nutrition, and ensuring safe and timely liberation from mechanical ventilation. Through the six vital elements, we unite to advocate for the well-being and recovery of our most vulnerable patients.

This episode is centered around the D Element: How to Assess, Prevent, and Manage Delirium.

GUEST
Heidi Smith, MD, MSCI
Professor of Anesthesiology and Pediatrics
Vanderbilt University Medical Center
Nashville, Tennessee, USA

HOST
Karen Choong, MB BCh, MSc
Professor, Department of Pediatrics and Critical Care
Department of Health Research Methods, Evidence and Impact
McMaster University
Hamilton, Ontario, CA

DATES
Initial Publication date: May 7, 2024