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Clinically Applied Pathophysiology Lecture Series

Didactic Course director: J Fitzgerald, MD

2009-2010 Reference Guide: Peds in Review: The Basics

Not to be missed!!!!!!! in RED

General References

Basic Science Highlighted in Green

9/14/2009	CPR/DNR New guidelines for CPR: 2005 Circulation: 2005 PALS recommendations New guidelines for pediatric CPR AAP News: New recs for pediatric CPR (Cliff Notes version) DNR order after 25 years First documented rhythm in cardiopulmonary arrest JAMA editorial: First documented rhythm Children and death: should children know that they are dying?	H Fagan , MD
9/21/2009	Body Fluids Basics: Salt and Water: Peds in Review Hypo- and hypernatremia :Peds in Review IV Fluids for seriously ill children Saline for gastroenteritis Dysnatremias and CNS injury Hyponatremia in hospitalized children Pouring salt on troubled waters: the British speak up Fluid resuscitation from shock Basic science: Aquaporin 4 Aquaporin 4 and brain edema Aquaporin 4 in experimental meningitis	J Fitzgerald , MD
9/28/2009	Electrolytes The Best Book Chapter EVER!	H Fagan, MD
10/5/2009	Blood and Blood Products Red cell transfusion basics: Peds in Review Transfusion in the critically ill 2008 Transfusion medicine: a good review from 1999 Serious hazards of transfusion(SHOT) in children A review of transfusion practice in children 2008 Transfusion in the PICU Transfusion of the neonate Transfusion related immunomodulation(TRIM) TRALI TRALI Health care worker's risks of accidental exposure Pediatric transfusion risks Transfusion in the ICU: be restrictive Anemia in the ICU Transfusion in the ICN Long term survivorship after transfusion in children	J Fitzgerald, MD
10/12/2009	Hematologic Emergencies Sickle Cell Disease: Peds in Review 2007 Sickle cell disease and stroke Sickle cell disease and stroke 2 Sickle cell disease and stroke: NEJM 2005 Chronic Transfusion to prevent stroke in SS disease Acute Chest in SS Disease Red Cell Exchange in SS Disease Pulmonary hypertension in SS Disease Massive transfusion and coagulation Leukoreduction for Leukemia?	R Wolfson, MD
10/19/2009	Acid Base Balance Acid Base Balance: Peds in Review Acid-Base Disorder Management: Part 1 Acid-Base Disorder Management: Part 2 Hypocapnia Lactic Acidosis Sodium bicarbonate: yes or no?? Hyperchloremic acidosis after .9NS DKA	H Fagan, MD
10/26/2009	Respiratory Failure (hypoxia and hypercarbia) Respiratory Failure: Peds in Review Physiology of hypoxia and hypercarbia Control of breathing in infants PGE2 and apnea Sensing hypoxia Oxygen sensing neurons	H Fagan, MD
11/2/2009	Respiratory Mechanics and Airway Obstruction Pulmonary Function Tests: Peds in Review Respiratory mechanics PFT's: More details The physiology of respiratory support	J Fitzgerald, MD
11/9/2009	ARDS/ Acute Hypoxic Respiratory Failure Basics of Acute Lung Injury 2007 ALI: Pathogenesis and Rational Management ARDS: A great Summary Article! ARDS The NEJM Review Pediatric ALI: Risks of mortality Low tidal volume ventilation: ARDS Network Prone position in children? Prone position? Fluid management in ALI/AHRF? Lung recruitment in ALI PEEP in ALI: how much is too much? Steroids??????? Surfactant??? NO???????? Long term follow up in children afterARDS	R Wolfson, MD
11/16/2009	Mechanical Ventilation VILI (Ventilator induced lung injury) Protective ventilator strategies Conventional ventilation in children From the NEJM, 1994 Hypercapnia as a result of protective strategy ventilation Tracheostomy in children Physiology of mechanical ventilation	C Montgomery, MD
11/23/2009	Mechanical Ventilation 2 Hi Fi Ventilation Hi Fi Ventilation 2 APRV Liquid ventilation ECMO	M Abe, MD
11/30/2009	Shock CIrculatory Shock: Peds in Review Vasodilatory Shock	H Fagan, MD
	The Physiology of Venous Return Guyton..the original! Guyton: Normal venous return curves experimental data Another way to look at Guyton Counterpoint to the classic teaching Counterpoint to the classic teaching AGAIN Guyton is correct Venous return: import to cardiac output The role of the vasculature in venous return	R Wolfson, MD
12/7/2009 12/14/2009	Sepsis Management Sepsis Physiology The word "sepsis" A review of sepsis Pathophys...1 Pathophys of organ dysfunction Cardiac dysfunction in sepsis Cardiac dysfunction in sepsis Sepsis, the basics Caspases and death in sepsis Adrenal insufficiency in sepsis GBS GBS, again MRSA Management of sepsis Surviving sepsis campaign Early goal directed therapy Promising therapies for sepsis Early diagnosis of neonatal sepsis HMGB-1? Nicotine? Cholinergic agonists and sepsis Lysophoshatidylcholine Activated protein C? Statins??	J Fitzgerald, MD R Wolfson, MD
	HOLIDAY BREAK !!!!!!!!!!!!!!!!!!
1/4/2010	Pharmacologic Support of the Circulation: Pressors Inotropes: classical and new Suanne's Powerpoint lecture Inotropes for heart failure Rational use in the premature? Prematures and inotropes Norepi v. dopamine Norepi v doamine #2 Dopamine in the SOAP study Dopamine: a review Dopamine? NO! Vasopressin after CPB Vasopressin Milrinone in CHD patients/ PRIMACORP Assist devices: A review BIVADs in children Assist devices in children 2 BNP...nesiritide??? Nesiritide????	J Fitzgerald, MD
	Cardiac Failure:systolic and diastolic dysfunction Cardiac Biology: a review of the last decade of discovery Excitation contraction coupling Channels and channelopathies Calcium handling and heart failure Heart failure: physiology and treatment Calcium and the heart From mice to men Biomechanical model of heart failure The G protein receptor Phospholamban Apoptosis in heart failure Genetics and genomics of heart failure Diastolic dysfunction Diagnostic criteria for diastolic dysfunction Diastolic dysfunction:CHARMES study Diastolic Dysfunction in sickle cell disease Pediatric Cardiomyopathy Cardiac dysfunction in OSA Drugs for Heart Failure: a great review The RAAS system and heart failure treatment Stem cells for heart disease	M Kahana, MD
1/11/2010	Congenital Heart Disease (CHD) 1: Presentation of the infant/child with CHD Embryology review of the heart Fetal and transitional circulation Fetal circulation with color pictures Presentation of children and infants with CHD Murmurs: PIR Heart murmurs Early Diagnosis of CHD The incidence of CHD Is the newborn exam enough? Pulse oximetry screening for CHD Antenatal diagnosis Other malformations associated with CHD Genetic Assembly of the Heart Genetics of heart disease.......brief review Development gone awry Genetic causes of CHD Survival of CHD to adulthood Adults with CHD.......so many more Athletics???	J Fitzgerald, MD
1/18/2010	CHD 2: Shunts The PFO The atrial septum ASD PDA Review The PDA VSD's AV canal....great pictures, old reference Eisenmenger's syndrome	J Fitzgerald, MD
1/25/2010	CHD 3: Valvular Heart Disease Valvular stenosis Valvular regurgitation Radiology of valvular disease The mitral valve The tricuspid valve Aortic stenosis Aortic regurgitation Mitral Stenosis Mitral regurgitation MURMURS and SOUNDS A primer on mumurs Valvular surgery	J Fitzgerald, MD
2/1/2010	CHD 4: Single Ventricle Physiology Summary article Dr. Daves' Slide Presentation PHOTO OP:single ventricle HLHS diagram Tricuspid atresia diagram Repair of the HLHS	J Fitzgerald, MD
	CHD 5: Surgical Repairs of CHD Lesions Helen Taussig.......... John Gibbon..father of CPB Pediatric cardiovascular surgery:1950-2000 Outcomes of "modern" neonatal surgery Adults with repaired CHD Outcome versus patient volume School performance, behavioral difficulties after heart surgery BT shunt. The first BT shunt The Norwood...picture The Hybrid repair of HLHS...picture Bidirectional Glenn...diagram The Fontan...diagram The Rastelli....diagram
2/8/2010	Rhythm Evaluation of a child with rhythm disturbance Pediatric dysrhythmias	J Fitzgerald, MD
2/15/2010	Increased ICP/ Herniation Syndromes Pediatric Head Injury: Peds in Review Minor head injury in children Short summary of pediatric severe head trauma management A Review of pediatric Stroke Prevention and treatment of ICP Inflicted v. non-inflicted head trauma: outcomes When do abuse victims present after an assault? Imaging head trauma patients:A review from the experts Head and spinal cord injury review Management strategies Neuroprotection of propofol Hypothermic neuroprotection Hypothermia? Perinatal hypothermia rhEpo in head injury: animal study Neuroprotection of GCSF	R Wolfson, MD T Koogler, MD
2/22/2010	Status Epilepticus Seizures in children part 1, a Review Seizures in children:part 2, a Review Hoehn Handout Status Epilepticus Outcomes of kids admitted to PICU with status Outcomes of neonates with seizures Status in encephalitis Choosing the first AED Epilepsy surgery review New anti-epileptic medications The ketogenic diet	T Koogler, MD
3/1/2010	Reading CT scans of the Head Pediatric Head Injury Imaging after head injury Imaging children after minor head injury Imaging: CT v. MRI for lumps and bumps Radiation dose from CT's for children Radiation from CT scans Utility of CT scans in abuse cases "Preliminary CT reads" Use of CT scans in a peds ED The reversal sign Telling families about radiation dose from CT scans	H Fagan, MD
3/8/2010	Renal Failure Renal replacement therapy Renal failure great review Another great review One more review Prevention of renal failure in the ICU Renal effects of critical illness Renal blood flow in sepsis Factors associated with mortality in ARF in children Renal failure in the ICU: multinational study Radiocontrast induced ARF Overall mortality declines in ARF No to renal dose dopamine Renal replacement modalities 1 Renal replacement therapy RRT in the ICU ESRD in kids <2	R Wolfson, MD J Curley, MD
3/15/2010	Brain Death Brain death in children Brain death in children: history and review Brain death in the newborn The ethics of brain death Brain death from the perspective of public policy Brainstem death, brief anatomy of the exam Death and brain death in the PICU Care of the brain dead donor	R Wolfson, MD
3/22/2010	Endocrine Issues in the PICU Neuroendocrine dysfunction in pediatric critical illness Consensus recommendations for corticosteroid replacement Adrenal insufficiency Adrenal insufficiency in sepsis Review of adrenal insufficiency in critical illness. steroids and sepsis 2002 CORTICUS trial: corticosteroids and sepsis, 2008 Basic science: mechanisms of adrenal insufficiency in sepsis Etomidate and adrenal insufficiency: the original report Duration of adrenal insufficiency after a single dose of etomidate CRASH trial: corticosteroids and traumatic brain injury Corticosteroids in ARDS The hypothalamic-pituitary-thyroid axis in critical illness: review Thyroid replacement after repair of congenital heart disease Endocrine Issues in the PICU 2: Glucose control in critical illness Yes or no: intensive insulin Rx No insulin perspective 2009..NICE SUGAR NEW article addressing children in PICU More questions about glucose control 2001 NEJM Lead article: Contol glucose JAMA 2003, more about glucose control Is it insulin or glucose control? NEJM 2006, the MICU story Nature weighs in Is there enough evidence? Maybe not so much...	C Montgomery, MD
3/29/2010	When the liver fails Acute liver failure in children- ALF in children	R Wolfson, MD
4/5/2009	Extra date if needed for scheduling