Nick Pigott's guest appearances

Nick Pigott

Coda Change

James Tooley

Chris Fox

Chris Nickson

John Hinds

Paul Marik

Zack Shinar

Joe Bellezzo

George Kovacs

Bryan Hayes

Rich Levitan

Karim Brohi

Sara Gray

Ashley Shreves

Jason Brooks

Darren Braude

OwlTail

Congenital heart disease isn't just diagnosed in the antenatal period and during post-natal examination. Nick Pigott takes us through the three main presentations of congenital heart disease (shock, cyanosis and heart failure) and reassures us that treating these patients is simpler than we think, urging us to consider cardiac disease in the sick newborn. He covers duct-dependent lesions, structural obstructive lesions, immediate resuscitation, the usefulness of physical examination, a deeper dive into hyperplastic left heart syndrome, the known cardiac patients (and what to do with them) and the paediatric cardiology wonder-drug: Prostaglandin infusion.

Congenital heart disease isn't just diagnosed in the antenatal period and during post-natal examination. Nick Pigott takes us through the three main presentations of congenital heart disease (shock, cyanosis and heart failure) and reassures us that treating these patients is simpler than we think, urging us to consider cardiac disease in the sick newborn. He covers duct-dependent lesions, structural obstructive lesions, immediate resuscitation, the usefulness of physical examination, a deeper dive into hyperplastic left heart syndrome, the known cardiac patients (and what to do with them) and the paediatric cardiology wonder-drug: Prostaglandin infusion.

Nick Pigott - Young at Heart

Kathryn Maitland

Kath Maitland takes the perspective that we should be cautiouswith how we give IV fluids. She argues that the underlyingphysiological evidence supporting the benefits of giving fluids isnot there. The findings of the FEAST study are clear. Kathdescribes how during FEAST, the administration of fluids made thechildren look better, and improved the recorded physiologicalparameters. However these surrogate outcomes did not translate to amortality benefit - fluid boluses were associated with increasedmortality. Nick, a paeds intensivist, retaliates with how it's really aboutunderstanding physiology. He defends the position we take at themoment and discusses the issues with the parameters used to assessfluid responsiveness, but urges that we shouldn't change everythingwe do at the moment until we understand the physiology better. Healso has nice description of the glycocalyx - "the pubic hair ofthe blood vessels, only more useful".

Kath Maitland takes the perspective that we should be cautious with how we give IV fluids. She argues that the underlying physiological evidence supporting the benefits of giving fluids is not there. The findings of the FEAST study are clear. Kath describes how during FEAST, the administration of fluids made the children look better, and improved the recorded physiological parameters. However these surrogate outcomes did not translate to a mortality benefit - fluid boluses were associated with increased mortality. Nick, a paeds intensivist, retaliates with how it's really about understanding physiology. He defends the position we take at the moment and discusses the issues with the parameters used to assess fluid responsiveness, but urges that we shouldn't change everything we do at the moment until we understand the physiology better. He also has nice description of the glycocalyx - "the pubic hair of the blood vessels, only more useful".

Kathryn Maitland vs Nick Pigott - Forget Physiology: Cautious Fluids Save Lives