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Pediatrics - Critical Care Medicine

Houston, Texas

BCM pediatricians care for children in various clinical and hospital environments.
Pediatrics - Critical Care Medicine
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Didactic Curriculum

A major strength of the fellowship program is the commitment to education. We offer a comprehensive didactic series in our weekly conferences. The fellows and staff play an active role in both scheduling and organizing these highly-valued educational activities.

One fellow assumes the responsibility of choosing an educational theme, choosing lecture topics, and inviting speakers for each two-month block of lectures. Being one of the largest pediatric departments in the country, the program is keen on using the collective expertise of colleagues within the Texas Medical Center to enrich these didactic series.

Didactic curriculum includes:

Journal Clubs

We review three articles monthly. Fellows under faculty guidance select clinical or basic science articles and review the study design and results in an evidence-based format.

Morbidity & Mortality Conferences

We review M&M cases monthly led by a fellow under faculty guidance with multidisciplinary participation from sub-specialists and pathologists.

Core Physiology Lectures

These conferences occur twice monthly and are structured as directed readings. Whereas faculty, fellows, and advanced practitioners attend these conferences, one fellow leads the group discussion of the topic. Two sessions involve a "hands-on" review of pathological specimens in the congenital heart disease museum under guidance of a Pediatric Pathologist.

Evidence-based Medicine Seminars

These conferences are held every other month. One fellow leads the group in performing an in-depth, evidence-based analysis of different types of studies under faculty guidance Fellows submit their formal appraisals for an online peer-reviewed publication to www.pedsccm.org. The goal of the series entitled "Seminars in Evidence-Based Medicine" is to put into practice the concepts of evidence-based medicine and basic statistics in order to develop effective appraisal skills and apply relevant results of research to clinical practice. Fellows practice these skills by performing in-depth reviews of peer-reviewed literature.

Patient Care Conferences

Led by a fellow under faculty guidance, these conferences offer an opportunity for in-depth review of the management of ICU patients. Fellows select patients to be reviewed under faculty guidance and frequently invite sub-specialty guests.

Research Conferences

As part of their fellowship requirements, all fellows will present their research to the pediatric critical care section. This will allow the fellow to share their work, hone their presentation skills, and gather recommendations from a wide variety of clinicians and researchers. In addition to the Fellows’ Research Conferences, there is a series of Faculty Research Conferences for the Critical Care faculty and staff to share their academic interests with the section.

Clinical updates from invited guest speakers

Fellows may invite speakers within the section or anywhere within the Texas Medical Center to attend and present at formal section conferences.

Joint Critical Care and Emergency Medicine Conferences

Twice each year, these sections meet jointly to critically evaluate the management of a group of common patients. These conferences serve as both educational sessions as well as opportunities for quality improvement.

Joint lectures for new Critical Care and Cardiology fellows

Throughout the year, these series of lectures are offered to provide a guide to common cardiac surgical procedures, basic principles of post-operative care, basic principles of temporary epicardial pacing, introduction to ECMO and cardiovascular pharmacology.
Although most of the core topics in pediatric critical care are repeated on a three-year cycle, the core physiology series (pulmonary, renal and cardiac physiology) is repeated yearly. (See the listing of these core physiology lectures below)

Core Physiology Series (Thursday mornings)

  1. Functional anatomy of the lung - prenatal/postnatal growth and development of the lungs, lymphatics and nerves
  2. Ventilation
  3. Pulmonary Circulation
  4. Diffusion of gases, oxyhemoglobin and carbon dioxide equilibrium
  5. Gas exchange and oxygen transport
  6. Acid-base equilibrium
  7. Cardiopulmonary interactions
  8. Pulmonary edema
  9. Applied respiratory physiology
  10. Renal physiology
  11. Acute renal failure
  12. CRRT and diuretics
  13. Cardiac catheter lab calculations
  14. Cardiovascular anatomy and pathology of congenital heart lesions - Part 1
  15. Cardiovascular anatomy and pathology of congenital heart lesions - Part 2
  16. Regulation of myocardial blood flow and oxygen consumption
  17. Cardiac contractility & pump function
  18. Physiology of congenital heart disease and absent pulmonary valve
  19. Applied Cardiac physiology

Cardiac pathophysiology and ancillary CCM topics (Wednesday mornings)

  1. Hemodynamic monitoring
  2. Monitoring tissue oxygenation
  3. Cardiopulmonary interaction
  4. Critical HF
  5. Mechanical circulatory devices
  6. Cardiac transplantation
  7. Pulmonary hypertension
  8. Conduction of CPB, CPB-induced SIRS & management of coagulation
  9. Left to right structural heart disease & LVOTO lesions
  10. Single ventricle physiology
  11. RVOT abnormalities
  12. Abnormalities of the origin of the great arteries
  13. Arrhythmias
  14. Professionalism
  15. Communication
  16. Quality Improvement
  17. Advanced biostatistics
  18. Mentor-mentee relationship

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