ATS Pediatric Core Curriculum 2024: The Role of the Pediatric Pulmonologist in the Intensive Care Unit.

Abstract

The American Thoracic Society Core Curriculum updates clinicians annually in relevant topics related to pediatric pulmonary diseases. This is a summary of the Pediatric Pulmonary Medicine Core Curriculum presented at the 2024 American Thoracic Society International Conference. The curriculum focused on clinical topics that are essential to caring for patients in the intensive care unit (ICU), highlighting the specific care of patients with severe asthma, pediatric acute respiratory distress syndrome (PARDS), hemoptysis and pulmonary hemorrhage, serious cardiovascular disease within the cardiac ICU and chronic respiratory failure. In the case of severe asthma, we review risk factors for ICU admission, adjunct pharmacologic therapies and appropriate ventilatory strategies. We discuss the highlights of the recently updated PARDS guidelines are offer further diagnostic stratification including possible and at risk categories to help facilitate early intervention and possibly prevent disease progression. Though relatively rare, pediatric hemoptysis and pulmonary hemorrhage can be devastating clinical scenarios and this review includes the discussion of pharmacologic and bronchoscopic interventions that should be considered in these cases. Additionally, we provide a summary of some of the common respiratory pathophysiology encountered in the cardiac ICU, as well as the diagnostic and therapeutic interventions available to the pulmonologist. Lastly, we review the decision-making considerations when transitioning patients from the ICU to chronic home mechanical ventilation. This manuscript aims to provide basic knowledge regarding each of these topics, in addition to up-to-date literature and resources for practicing pulmonologists and trainees.