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Grand Rounds: Pediatric Care in the Age of Information and The Impact of Therapeutic Plasmic Exchange on Critically Ill Children who require CKRT

04-21-2023

By Claire Hanson, MD, and Jonathan Pelletier, MD , Akron Children's, Akron, OH

Critical Care Medicine (PICU) , Hospital Medicine

More about Claire Hanson, MD
More about Jonathan Pelletier, MD


Objectives (Educational Content) :

1. Define the term 'health informaticist' and their role at Akron Children's. 2. Summarize advances in prediction algorithms for bronchiolitis. 3. Explain the potential and limitations of artificial intelligence in healthcare. 4. Understand how sequential and progressive multiple organ dysfunction in critical illness presents a treatment challenge to intensive care physicians and threatens morbidity and mortality in critically ill patients. 5. Explain how plasma exchange therapy seems to benefit patients with multiple organ dysfunction by clearing pro-thrombotic mediators and replacing these with normal plasma and interrupting the cycle of microcirculatory ischemia, shock, reperfusion, inflammation, and coagulopathy. 6. Describe how plasma exchange therapy is associated with Major Adverse Kidney Event outcomes 90 days following the initiation of CKRT in the research presented.

Target Audience:

General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists, and nurses.

Identified Gap:

Health informaticist allows for applying computer and information science to healthcare to focus on using information science to improve health outcomes using a variety of mechanisms such as descriptive statistics, population health / geocoding, and predictive modeling. Multiple organ dysfunction in critical illness presents a treatment challenge to intensive care physicians and threatens morbidity and mortality in critically ill patients. The use of plasma exchange therapy seems to benefit these patients interrupting the cycle of microcirculatory ischemia, shock, reperfusion, inflammation, and coagulopathy.

Estimated Time to Complete the Educational Activity:

1 hour(s)

Expiration Date for CE/CME Credit:

04-19-2024

Method of Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CE/CME credit.

Disclosure:

Claire Hanson, MD, and John Pelletier, MD, have identified that they have no financial relationships with any ineligible companies.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit TM.  Physicians should only claim the credit commensurate with the extent of their participation in the activity.

Bibliography:

Baughman RP, Lower EE, Flessa HC, Tollerud DJ: Thrombocytopenia in the intensive care unit. Chest 1993; 104(4):1243-1247

Nguyen T, Hall M, Han Y, Fiedor M, et al: Microvascular thrombosis in pediatric multiple organ failure: Is it a therapeutic target? Pediatr Crit Care Med 2001; 2(3):187-196

Khemani RG, Bart RD, Alonzo TA, Hatzakis G, et al: Disseminated intravascular coagulation score is associated with mortality for children with shock. Intensive Care Med 2009; 35(2):327-333

Sevketoglu E, Yildizdas D, Horoz OO, Kihtir HS, et al: Use of therapeutic plasma exchange in children with thrombocytopenia-associated multiple organ failure in the Turkish thrombocytopenia-associated multiple organ failure network. Pediatr Crit Care Med 2014; 15(8):e354-359

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