PARDS--Beyond the Basics Part 1 with Dr. Nadir Yehya: Noninvasive Ventilation

Jan 2, 2023

Dr. Nadir Yehya, a pediatric critical care specialist, discusses the use of non-invasive ventilation in capturing kids with developing ARDS early and challenges in designing trials for pediatric ARDS research. The podcast explores the use and effectiveness of high flow nasal cannula in clearing dead space in the respiratory system. It also discusses the relationship between head size and babies' breathing, mechanisms and benefits of high flow ventilation, and situations where high flow may be tried even if intubation is not desired.

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Introduction

00:00 • 4min

Challenges in Designing and Executing Trials for Pediatric ARDS Research

03:47 • 3min

The Role of High Flow Nasal Cannula in Respiratory Illness in Children

06:31 • 2min

Impact of Head Size on Babies' Breathing and Mechanisms of High Flow

08:14 • 1min

Mechanisms and Benefits of High Flow Ventilation

09:24 • 23min

Dr. Yehya is a graduate of the University of California at Berkeley and the University of California at Los Angeles School of Medicine. After completing pediatrics training at Children’s Hospital of Los Angeles, he completed his pediatric critical care fellowship at Children’s Hospital of Philadelphia (CHOP), and joined the faculty after graduation in 2011. He is currently an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the pediatric intensive care unit at CHOP.

Dr. Yehya’s research interests encompass all aspects of pediatric respiratory failure, with a particular emphasis on pediatric acute respiratory syndrome (ARDS) and mechanical ventilation. ARDS consists of sudden, severe flooding of the lungs in response to an inflammatory insult causing difficulty breathing, frequently requiring mechanical ventilation. Sepsis is a leading cause of ARDS in children. His long-term goal is better characterization of ARDS in children and to test therapies designed to improve outcomes. His NIH-funded work is assessing the utility of specific plasma biomarkers in pediatric ARDS, with subsequent proteomic characterization and testing in pre-clinical models. Dr. Yehya has several active studies involving biomarkers, clinical epidemiology, and pathophysiological mechanisms in the field of pediatric ARDS, and is involved in several multicenter and multinational collaborations.

Objectives:

After listening to this episode, learners should be able to:

Understand the role of heated high-flow nasal cannula and non-invasive mechanical ventilation in the management of pediatric acute respiratory distress syndrome (PARDS).
Recognize the potential for patient self-inflicted lung injury in PARDS.
Recognize high-risk situations when non-invasive mechanical ventilation is relatively contraindicated in favor of intubation and mechanical ventilation.

Acknowledgement:
Thank you to Dr. Nick Bartel for his help in creating learning objectives for this series.

Selected references:

PMID: 10793162
PMID: 25693014
PMID: 15269312
PMID: 30361119
PMID: 17426195
PMID: 31112383
PMID: 25647235
PMID: 19001507
PMID: 32043986
PMID: 15671432

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Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!