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High-Flow Nasal Cannula vs CPAP in Acutely Ill Children by P. Ramnarayan | OPENPediatrics
In this World Shared Practice Forum Podcast, Dr. Padmanabhan Ramnarayan discusses the findings of the clinical trial comparing high-flow nasal cannula (HFNC) therapy to continuous positive airway pressure (CPAP) therapy in pediatric critical care. The trial, which was published in JAMA, explores the effectiveness of HFNC as a non-inferior alternative to CPAP for respiratory support in acutely ill children. Dr. Ramnarayan reviews the trial’s design, key outcomes, and implications for clinical practice, providing valuable insights for healthcare professionals involved in pediatric respiratory care. LEARNING OBJECTIVES - Understand the design and methodology of the clinical trial comparing HFNC and CPAP in pediatric critical care - Identify the primary and secondary outcomes of the trial and their significance - Discuss the implications of the trial findings for clinical practice and future research in pediatric respiratory care AUTHORS Padmanabhan "Ram" Ramnarayan, MBBS, MD, FRCPCH, FFICM Professor of Paediatric Critical Care Imperial College London Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: August 26, 2025. ARTICLES REFERENCED Ramnarayan P, Richards-Belle A, Drikite L, et al. Effect of High-Flow Nasal Cannula Therapy vs Continuous Positive Airway Pressure Therapy on Liberation From Respiratory Support in Acutely Ill Children Admitted to Pediatric Critical Care Units: A Randomized Clinical Trial. JAMA. 2022;328(2):162-172. doi:10.1001/jama.2022.9615 RENOVATE Investigators and the BRICNet Authors, Maia IS, Kawano-Dourado L, et al. High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial. JAMA. 2025;333(10):875-890. doi:10.1001/jama.2024.26244 Pelletier JH, Maholtz DE, Hanson CM, et al. Respiratory Support Practices for Bronchiolitis in the Pediatric Intensive Care Unit. JAMA Netw Open. 2024;7(5):e2410746. Published 2024 May 1. doi:10.1001/jamanetworkopen.2024.10746 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/whctgh753rgnhc7rxn7w3mn/20250712_WSP_Ramnarayan_Transcript 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 thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Ramnarayan P, O'Hara JE, Burns JP. High-Flow Nasal Cannula vs CPAP in Acutely Ill Children. 08/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/high-flow-nasal-cannula-vs-cpap-in-acutely-ill-children-by-p-ramnarayan-openpediatrics
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Brushing Up on High-Quality Oral Health Care for Children with Medical Complexity
In this Complex Care Journal Club podcast episode, Dr. Robbie Dembo and Ms. Kate Honsberger discuss a mixed methods study of oral health experiences and disparities among children with special health care needs. They describe oral health problems faced by children with medical complexity, barriers to high-quality dental care reported by family caregivers, and strategies for disseminating findings from their study. SPEAKERS Robbie Dembo, PhD Senior Research Scientist Principal Investigator National Opinion Research Center (NORC) University of Chicago Kate Honsberger, BA Director, Health Care Programs National Opinion Research Center (NORC) University of Chicago HOST Kristina Malik, MD Assistant Professor of Pediatrics, University of Colorado School of Medicine Medical Director, KidStreet Pediatrician, Special Care Clinic, Children's Hospital Colorado DATE Initial publication date: August 11, 2025. JOURNAL CLUB ARTICLE NORC at the University of Chicago. Oral Health Among Children with Special Health Care Needs. Accessed August 4, 2025. https://www.norc.org/research/projects/oral-health-children-special-health-care-needs.html OTHER ARTICLES REFERENCED Child and Adolescent Health Measurement Initiative. Shared care planning for children with special health care needs. Accessed August 4, 2025. https://www.cahmi.org/our-work-in-action/engagement-in-action/cshcn Cohen E, Kuo DZ, Agrawal R, Berry JG, Bhagat SK, Simon TD, Srivastava R. Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics. 2011 Mar;127(3):529-38. doi: 10.1542/peds.2010-0910. Epub 2011 Feb 21. PMID: 21339266; PMCID: PMC3387912. Yu JA, McKernan G, Hagerman T, Schenker Y, Houtrow A. Identifying children with medical complexity from the National Survey of Children’s Health combined 2016–17 data set. Hospital Pediatrics. 2021;11(2):192- 197. doi:10.1542/hpeds.2020-0180 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/9767nfr2rj79c2hft2cc3g8/Dembo_and_Hornsberget_final_8-7-25‌ 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: https://forms.gle/Bdxb86Sw5qq1uFhW6. 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 thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Dembo R, Honsberger K, Malik K. Brushing Up on High-Quality Oral Health Care for Children with Medical Complexity. 08/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/brushing-up-on-high-quality.
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Families Face Ethical Challenges More Often Than They Change a G Tube: Rethinking Our Care
In this Complex Care Journal Club podcast episode, Dr. Miriam Shapiro, Ms. Kate Detwiler, and Dr. Vanessa Madrigal discuss a survey of families with children with chronic conditions about ethical challenges they have experienced in their child's care and sources of support. They describe the residual distress reported by families, implications for clinical practice, and next steps from this work. SPEAKERS Miriam Shapiro, MD Associate Professor‌, Affiliate Faculty, and Pediatric Intensivist University of Minnesota Medical School University of Minnesota Center for Bioethics Masonic Children's Hospital Kathryn Detwiler, MBA Parent Advocate, Parent Researcher Program Manager, Complex Care Children's National Hospital Vanessa Madrigal, MD, MSCE, HEC-C Associate Professor, Director Pediatric Ethics Program, and Pediatric Critical Care Medicine The George Washington University Children's National Hospital HOST Kathleen Huth, MD, MMSc Pediatrician, Complex Care Service, Division of General Pediatrics Boston Children's Hospital Assistant Professor of Pediatrics Harvard Medical School DATE Initial publication date: July 7, 2025. JOURNAL CLUB ARTICLE Shapiro MC, Detwiler K, Shepard J, Bernhard T, Li X, Boss RD, Madrigal VN. Ethical Challenges in Pediatric Medical Complexity: A Survey of Parents. J Pediatr. 2025 Apr;279:114478. doi: 10.1016/j.jpeds.2025.114478. Epub 2025 Jan 27. PMID: 39864504; PMCID: PMC12013584. OTHER ARTICLES REFERENCED Cho HL, Grady C, Tarzian A, Povar G, Mangal J, Danis M. Patient and Family Descriptions of Ethical Concerns. Am J Bioeth. 2020 Jun;20(6):52-64. doi: 10.1080/15265161.2020.1754500. PMID: 32441594; PMCID: PMC7673656. Pang J, Batson L, Detwiler K, Miller ME, Thorndike D, Boss RD, Shapiro MC. Where do families turn? Ethical dilemmas in the care of chronically critically Ill children. Monash Bioeth Rev. 2024 Jul 8. doi: 10.1007/s40592-024-00201-6. Epub ahead of print. PMID: 38976209. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/p9cpbchs45rp3xq8p747pv83/July_CCJCP_Shapiro_Madrigal_Detwiler_Transcript_7-2-25‌ 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: https://forms.gle/Bdxb86Sw5qq1uFhW6. 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 thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Shapiro MC, Detwiler K, Madrigal VN, Huth K. Families Face Ethical Challenges More Often Than They Change a G Tube: Rethinking Our Care. 7/2025. OPENPediatrics. https://soundcloud.com/openpediatrics/families-face-ethical-challenges-more-often-than-they-change-a-g-tube-rethinking-our-care.
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Independent Double Checks and Line Reconciliation by J. Murphy, K. Gustafson | OPENPediatrics
This podcast discusses the preoperative, operative, and postoperative considerations for patients undergoing tonsillectomy, including anatomy and pathophysiology, preoperative evaluation, anesthetic management, operative approach, and postoperative care. LEARNING OBJECTIVES Upon listening to this podcast, learners will be able to: • Identify high-alert medications that may require an independent double check (IDC) • Describe how confirmation bias can negatively impact an independent double check • Describe the steps of an independent double check for intermittent and continuous medications AUTHORS Julie A. Murphy, PhD, MBA, RN, CPHQ Senior Clinical Quality Improvement Specialist Clinical Education, Informatics, Quality, and Practice Boston Children's Hospital Kathryn Gustafson, BSN, RN, CPST Clinical Quality Improvement Specialist CEI, Quality and Professional Practice Boston Children's Hospital DATES Initial publication date: July 2, 2025. 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: [email protected] CITATION Murphy JA, Becla K, Donovan K, Miller DM, Paulson A, Treseler J, DeGrazia M, Gustafson K. Independent Double Checks and Line Reconciliation. 07/2025. OPENPediatrics. Podcast: https://soundcloud.com/openpediatrics/independent-double-checks-and-line-reconciliation-by-j-murphy-k-gustafson-openpediatrics?si=5de838d7cc36468abc6168889e0f74b2&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing.
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Global PARITY Study: Pediatric Critical Illness Insights by T. Kortz, A. Holloway | OPENPediatrics
This World Shared Practice Forum reviews the Global PARITY study, a comprehensive research initiative aimed at understanding and addressing pediatric critical illness in resource-constrained settings. The discussion highlights the methodology, challenges, and key findings of the study, emphasizing the high prevalence of critical illnesses such as pneumonia, sepsis, and malaria among children in low socio-demographic index regions. The authors stress the importance of basic critical care interventions and the need for global health equity, advocating for the integration of critical care into health systems worldwide. LEARNING OBJECTIVES - Understand the methodology and challenges of conducting the Global Parity Study in resource-constrained settings. - Identify the most common pediatric critical illnesses and their prevalence in low socio-economic regions. - Recognize the importance of basic critical care interventions in improving health outcomes for critically ill children. - Appreciate the role of global health equity and the need for integrating critical care into health systems. - Explore the potential impact of research findings on policy decisions and resource allocation in healthcare. AUTHORS Teresa Kortz, MD, MS, PhD Associate Professor of Clinical Pediatrics University of California, San Francisco Adrian Holloway, MD Associate Professor Pediatrics University of Maryland School of Medicine, Department of Pediatrics 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 DATE Initial publication date: June 23, 2025. ARTICLE REFERENCED Kortz TB, Holloway A, Agulnik A, et al. Prevalence, aetiology, and hospital outcomes of paediatric acute critical illness in resource-constrained settings (Global PARITY): a multicentre, international, point prevalence and prospective cohort study. Lancet Glob Health. 2025;13(2):e212-e221. doi:10.1016/S2214-109X(24)00450-9 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/sf6v5frcmb9j5pt3vrrss67/Kortz__Holloway_PWSP_June_2025_Transcript 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: [email protected] Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause. CITATION Kortz TB, Holloway A, Wolbrink TA. Global PARITY Study: Pediatric Critical Illness Insights. 06/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/global-parity-study-pediatric-critical-illness-insights-by-t-kortz-a-holloway-openpediatrics.
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