Bronchiolitis is THE standard illness for paediatric intensivists. Dozens of patients every season, all the same age, size, and type But are they the same? What is bronchiolitis? How should we treat it? Does High Flow Nasal Cannulae treatment work: and what is it actually? What about fluids, ventilation modes, Read more…
Our patients are sick and it makes sense that they need lots of blood. Surely more blood means more oxygen to the tissues which is good… or is it? Why are things not so clear? When should we transfuse our patients? Why are transfusions bad? Is it the blood, the Read more…
Nutrition on children’s intensive care is difficult and is not always a priority. The focus is on survival and the ABC, not the niceties of feeding. However our patients are in an extreme metabolic state and may well be catabolic. How do we prevent this and how do we improve Read more…
In PicPod 12 we revisit some of the themes of PicPod 6. Sedation is difficult to get right, and we can do much harm if we give too much, or not enough. How bad are some of the drugs we use? How much are benzodiazepines linked to delirium? Can we Read more…
Picpod 11 puts it all in to context. Hans Jorg Lang is an intensivist who works with Medicins Sans Frontiers in a variety of countries in Sub Sahara Africa, including Malawi and Congo. Including a guest appearance by David Bird, an intensive care trainee. What is the value of a Read more…
Picpod 10 is based on an interview with Pat Kochanek from Pittsburgh, who is also the editor in chief of PCCM. He has done much lab based and patient based work on traumatic brain injury, and talks about the next level of TBI treatments. TBI is intensely frustrating: so much Read more…
PicPod 9 features Joseph Manning, who specialises in research in to the family centered outcomes of PIC patients. We get so caught up in the technicalities of our patients, do we forget to look after the wider family? Who looks after the siblings, and what damage might we be doing? Read more…
With excellent timing (see the NEJM publication of the PARAMEDIC2 study), Mike Shepherd from Starship Hospital in Auckland, New Zealand discusses the use of adrenaline in paediatric cardiac arrest. Does it work? What does “work” mean? Is the outcome return of circulation, or should we also be thinking about neurological Read more…
Welcome to PicPod 7. Martin Kneyber from the Netherlands was kind enough to talk to me in Singapore. He is part of the PROSpect trial, which is a 2×2 trial in to HFOV / conventional ventilation, and prone/supine positioning. Should HFOV be abandoned? If not, why not? Why have adult Read more…
How sedated should our patients be? How should we sedate our patients? Two similar but actually different questions. Monique van Dijk from Rotterdam was part of a debate in Singapore: should patients be sedated more deeply, or should they have episodic agitation and distress? Which is worse, which is better? Read more…