Welcome new #PedsICU fellows! As you get oriented, we are excited to share our newly created Audio Learning Bootcamp! 🎧 This is a collation of episodes highlighting the most fundamental concepts & cases as you start to build your ICU foundations! 🎙️: picudoconcall.org/637-2/

○ Vasopressin works independently of the adrenergic receptors. Consider in refractory vasodilatory shock. ○ Learn more about vasopressors with our episode from PICU Doc On Call Bootcamp: podcasts.apple.com/us/podcas… #PedsICU

📛The use of Norepinephrine without adequate intravascular volume, may elevate the blood pressure without improving end organ perfusion. 🛠️Norepinephrine should be administered with repletion of intravascular volume.

📛Norepinephrine should be administered through central line, except in extreme emergency. 🛠️Norepinephrine extravasation is treated with Phentolamine - non-selective alpha blocker.

☑ Eculizumab, which binds to C5 and inhibits activation of complement pathway, is used in management of atypical HUS. onset of action is within hours. 🎙️Check out our episode about Hemolytic Uremic Syndrome: shorturl.at/fRVDV #PedsICU

▫ The recommended Echo view in evaluation of hemodynamic instability of unknown etiology is “Subcostal 4-chamber”. ▫ The goal is to get quick view and minimize interruptions of chest compression and defibrillation. ▫ Also, you need to minimize the ultrasound gel placed on the chest as it conducts electricity given for defib. #PedsICU

💎 Clinical pearl ▫Early fluid resuscitation in patients with STEC-HUS is linked to improved short and long-term outcomes ▫Higher hematocrit value at presentation is a predictor of poor outcome and development of oligoanuric HUS Check the following articles for further read: shorturl.at/jvpcX shorturl.at/G72bO

⬨Electrolytes should be monitored frequently during loading and maintenance infusions of sodium phenylacetate-sodium benzoate because these medications contain high concentrations of sodium and chloride. Sodium phenylacetate administration may cause potassium depletion.

▪ Kussmaul breathing in urea cycle defects might result in respiratory alkalosis. ▪ Ammonul is a combination of sodium phenylacetate and sodium benzoate. ▪Ammonul is used as nitrogen scavenger to treat hyperammonemia in cases of urea cycle defects. Hyperammonemia episode: shorturl.at/jBrux #PedsICU

❓Which metabolic condition associated with respiratory alkalosis and hyperammonemia? ✅Urea Cycle Defects. Of the most common types; ▪OTC (ornithine transcarbamylase) deficiency is X-linked recessive with high orotic acid levels. ▪CPS (Carbamoyl phosphate synthetase) deficiency is autosomal recessive, characterized by low orotic acid levels. #PedsICU

The four main causes of hypoxemia are: ▪ Alveolar hypoventilation: Normal A-a gradient ▪ Diffusion defect: High A-a gradient ▪ V/Q mismatch: High A-a gradient ▪ Anatomic right to left shunt: High A-a gradient - supplemental oxygen is ineffective in correcting hypoxemia New Episode 🔗: shorturl.at/fxAL1 Alveolar gas equation #PedsICU

It's an honor to be featured with an international cohort of audio-learning educators on the most recent @OPENPediatrics World Shared Practice Forum Podcast! Here's a compiled list of the most popular PICU podcasts: bit.ly/4bbDrjM #PedsICU

▪Malignant Hyperthermia susceptibility (MHS) is autosomal dominant (AD) condition with variable penetrance and expressivity. ▪High index of suspicion especially in the setting of positive family history is critical.

Since the introduction of Dantrolene, the mortality rate in Malignant Hyperthermia went down from 70% in 1960s to about 15%. Dantrolene should be administered without delays. New Episode 🔗: shorturl.at/gpAKX Management of MH in the PICU! #PedsICU