We’re back with another great chat, this time with Dr Brad MacDonald from Perth Children’s Hospital. Brad currently works in paediatric medicine as a paediatric trainee as well as being enrolled in a PhD at the UWA School of Population and Global Health. Brad discusses his journey from being a science student, through to enrolling in Medicine and now specialising in paediatrics. We talk in depth about rheumatic heart disease (the subject of Brad’s PhD) which is a major problem in many rural and remote communities in Australia. There is also a twist part way through our chat with Brad when he recounts his own experience of being diagnosed with septic shock and how he was lucky to make it through after an extended stay in the intensive care unit and months of hospitalisation and rehabilitation. Based on the unique combination of his clinical knowledge and lived experience, Brad is called on to provide evidence relating to septic shock to a range of different forums with the aim of improving how septic shock patients are managed from diagnosis and treatment, through to recovery and rehabilitation.
You can read more about Brad and his research here: https://research-repository.uwa.edu.au/en/persons/bradley-macdonald
Previous episodes of the podcast that we mention during our conversation are:
Episode 64 – StoP Trial, Aboriginal Skin Health: https://soundcloud.com/meaningofhealth/episode-64-stop-trial-aboriginal-skin-health?si=b5f7b585b29e41ddb98add459c553bd8&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing 
Episode 77 – Treating Septic Shock with Dr Stephen MacDonald and Jono Burcham: https://soundcloud.com/meaningofhealth/episode-77-treating-septic-shock-with-dr-stephen-macdonald-and-jono-burcham?si=144da226cf0f42f7afe42ea57170bd04&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing 
As always, if you want to get in touch with the podcast, you can contact us at: meaningofhealth@outlook.com or via twitter @healthmeanswhat or via FaceBook @MeaningofHealth or via Instagram @healthmeanswhat

Episode 81 - Paediatric Medicine And Surviving Septic Shock With Dr Brad MacDonald

In this World Shared Practice Forum podcast, Drs. Suchitra Ranjit and Luregn Schlapbach, discuss a framework to provide individualized hemodynamic support for pediatric patients with septic shock, especially those in lower and middle-income countries. The authors discuss considerations described in their expert group's recent article, including how to administer and assess the response of various therapies such as fluids, inotropes, and pressors.
LEARNING OBJECTIVES
By the end of this podcast, learners will be able to:
- Describe the challenges to the early recognition of septic shock in children through a global lens
- Introduce the concepts of flow, pressure, and filling in the context of septic shock and their clinical application
- Discuss the individualized approach to fluid use in the treatment of septic shock in pediatric patients
- Review the literature surrounding the use of fluids in pediatrics and adults

AUTHORS
Suchitra Ranjit, MD
Chief, Pediatric Intensive Care Unit
Apollo Children's Hospital, Chennai, India

Luregn Schlapbach, Prof, MD, PhD, FCICM
Head, Department of Intensive Care and Neonatology
University Children`s Hospital Zurich, Switzerland

DATES:
Initial publication: August 22, 2023

CITATION:
Ranjit S, Schlapbach LJ, O’Hara JE, Wolbrink TA. Individualized Hemodynamic Support for Pediatric Patients with Septic Shock. 08/2023. OPENPediatrics. Online Podcast. YT: https://youtu.be/AK6Uz_hZ_SY SC: https://soundcloud.com/openpediatrics/individualized-hemodynamic-support-for-pediatric-patients-with-septic-shock.

ARTICLED REFERENCED:
- Ranjit S, Kissoon N, Argent A, et al. Haemodynamic support for paediatric septic shock: a global perspective. Lancet Child Adolesc Health. 2023;7(8):588-598. doi:10.1016/S2352-4642(23)00103-7
- Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223-230. doi:10.1016/S2213-2600(18)30063-8 (1:15)
- Maitland K, Kiguli S, Opoka RO, et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med. 2011;364(26):2483-2495. doi:10.1056/NEJMoa1101549 (4:58)
- Gu W, Deng X, Lee M, et al. Rapid pathogen detection by metagenomic next-generation sequencing of infected body fluids. Nat Med. 2021;27(1):115-124. doi:10.1038/s41591-020-1105-z (14:02)
- Meyhoff TS, Hjortrup PB, Wetterslev J, et al. Restriction of Intravenous Fluid in ICU Patients with Septic Shock. N Engl J Med. 2022;386(26):2459-2470. doi:10.1056/NEJMoa2202707 (24:50)
- National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network, Shapiro NI, Douglas IS, et al. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. N Engl J Med. 2023;388(6):499-510. doi:10.1056/NEJMoa2212663 (24:52)

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

Individualized Hemodynamic Support for Pediatric Patients with Septic Shock by S. Ranjit, et al.

In this World Shared Practice Forum Podcast, authors of the newly released publication, International Consensus Criteria for Pediatric Sepsis and Septic Shock, review their research and findings for treating and caring for children with sepsis and septic shock. They discuss how using the novel Phoenix Sepsis Score guided the development of this new globally applicable research model.

LEARNING OBJECTIVES
Upon listening to this presentation, learners will be able to:
- Describe the goals and development of the new Phoenix Sepsis Score
- Discuss how clinicians can apply the score in clinical practice and for research endeavors
- Explain the challenges and limitations of using the Phoenix Sepsis score in lower-resource settings

AUTHORS
Luregn Schlapbach, MD, PhD, Prof, FCICM
Head, Department of Intensive Care and Neonatology
University Children’s Hospital in Zurich, Switzerland

Scott Watson, MD, MPH
Professor of Pediatrics
University of Washington School of Medicine
Associate Division Chief
Division of Pediatric Critical Care Medicine
Seattle Children’s Hospital

Claudio Flauzino de Oliveira, MD, PhD
Researcher
Latin American Sepsis Institute

Halden Scott, MD, MSCS
Director of Research
Section of Pediatric Emergency Medicine
University of Colorado School of Medicine
Children’s Hospital Colorado

Tellen Bennett, MD, MS
Professor of Biomedical Informatics and Pediatrics
Vice Chair of Clinical Informatics
Department of Biomedical Informatics
University of Colorado School of Medicine
Attending Physician
Pediatric Intensive Care Unit
Children’s Hospital Colorado

Traci Wolbrink, MD, MPH
Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine
Boston Children's Hospital
Associate Professor of Anesthesia
Harvard Medical School

DATES
Initial publication date: March 26, 2024.

ARTICLES REFERENCED
Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock
https://jamanetwork.com/journals/jama/fullarticle/2814296

Global Study of Disease
https://pubmed.ncbi.nlm.nih.gov/31954465/
        
Sepsis-3
https://jamanetwork.com/journals/jama/fullarticle/2492881

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

CITATION
Schlapbach LJ, Bennett TD, de Oliveira CF, Scott HF, Watson RS, O’Hara JE, Wolbrink TA. New Phoenix Pediatric Sepsis Criteria. 03/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/new-phoenix-pediatric-sepsis-criteria.

New Phoenix Pediatric Sepsis Criteria by L. Schlapbach et al | OPENPediatrics

For Sepsis Awareness Month, Dr Marilena Giannoudi speaks with Dr Ron Daniels about sepsis. They discuss the causes, investigation, management, and prevention of sepsis. Topics include the Sepsis 6 and escalation of care, use of blood cultures, septic shock, and post-sepsis syndrome.

Dr Ron Daniels is an NHS Consultant in Intensive Care, based at University Hospitals Birmingham, U.K. He’s also Founder and Chief Executive of the UK Sepsis Trust and Vice-President of the Global Sepsis Alliance. In 2016 he was awarded the British Empire Medal for services to patients. Ron’s expertise lies in translational medicine and leadership. He leads the team driving dissemination of the Sepsis 6 treatment pathway and is part of the team responsible for much of the policy and media engagement around sepsis in the U.K. and elsewhere, including as a core member of the team securing the adoption of the 2017 Resolution on Sepsis by the World Health Organization (WHO). At home, Ron’s worked with the NHS over the last 9 years to ensure that by 2019, in England, more than 80% of patients presenting with suspected sepsis were receiving appropriate antimicrobials rapidly. He is now leading a team working with His Majesty’s Government to once again drive sepsis improvement work in the post pandemic era. He’s ever mindful of the perceived conflict, and the synergies and need for collaboration, with the antimicrobial stewardship agenda.

Dr Marilena Giannoudi is a clinical academic trainee in cardiology in the Yorkshire and Humber region. Her current interests include heart failure, endothelial dysfunction, and medical education. She is a Fellow of the Higher Education Academy and is currently pursuing a PhD. Dr Giannoudi is passionate about ensuring that trainees' voices are heard and that educational opportunities are available to foster confidence and independence throughout their training. She has developed core medical training (now IMT) teaching programs in hospitals across her deanery. Additionally, she uses her position on the local junior doctor body to advocate for and implement necessary changes.

-- Links --
The UK Sepsis Trust's Clinical Tools - https://sepsistrust.org/healthcare-professionals/clinical-tools/
NICE guidelines on suspected sepsis - https://www.nice.org.uk/guidance/NG51
Global Sepsis Alliance - https://globalsepsisalliance.org/

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Recording date: 11 September 2024

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Clinical Conversations

Sepsis (13 Sep 2024)

RCPE's Podcast Series 'Clinical Conversations' by the Trainees & Members' Committee (T&MC) and 'COVID-19 Conversations'.

A podcast that explores a range of health and health-related issues that affect people in the community. We sit down with lived experience, academic, and practitioner experts to take a deep dive into many different areas of health. We are based at the School of Population and Global Health at the University of Western Australia.

New tracks tagged #septic shock