# Peritoneal Dialysis Access — GCMD Library living collection

Also covered as: severe acute kidney injury · congenital heart disease · bladder outlet obstruction · chronic kidney disease · posterior urethral valves · inguinal hernia · oligohydramnios · anuria

Experts: Dr. Maria Alonso, Dr. Lizzie Lee, Dr. Paul Kingma, Dr. Jan Scober

Updated: n/a · 12 episodes · 211 cited statements

## Episodes
### Medical Management
- [Managing Advanced Chronic Kidney Disease: Cincinnati Fetal Center](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622) — video · 35:10 · [machine version](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622.md)
- [Fetal management of advanced chronic kidney disease: Fetal Genitourinary...](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916) — video · 34:05 · [machine version](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916.md)

### Surgical Management
- [Renal transplantation: Cincinnati Fetal Center](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623) — video · 13:51 · [machine version](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623.md)
- [Renal transplantation: Fetal Genitourinary Disease 2015](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915) — video · 13:44 · [machine version](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915.md)

### Evidence & Research
- [Early Peritoneal Dialysis and Postoperative Outcomes in Infants After Pediatric Cardiac Surgery](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220) — video · 0:47 · [machine version](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220.md)
- [Quick Literature Updates Episode 13](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638) — video · 4:12 · [machine version](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638.md)
- [Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554) — video · 0:54 · [machine version](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554.md)
- [Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in th](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114) — video · 0:53 · [machine version](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114.md)
- [Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117) — video · 0:53 · [machine version](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117.md)
- [Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127) — video · 0:53 · [machine version](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127.md)
- [Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery...](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128) — video · 0:53 · [machine version](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128.md)

### In-Depth Reviews
- [PDC 2020 Practice Gaps](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998) — video · 83:26 · [machine version](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554?t=0) Surgeon Volume and Inguinal Hernia Recurrence (Ep 8)
- [0:00](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=0) Early surgical interventions: G-tubes and PD catheters (Ep 3)
- [3:28](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=208) Renal transplantation technique and complications (Ep 3)
- [6:40](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=400) Technical discussion: G-tube placement strategies (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=0) Early Peritoneal Dialysis After Pediatric Cardiac Surgery (Ep 6)
- [0:00](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=0) Pulmonary Survival in Fetal Genitourinary Disease (Ep 4)
- [6:10](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=370) Case Presentation and CKD Management Principles (Ep 4)
- [20:22](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1222) Dialysis Indications and Transplantation (Ep 4)
- [25:35](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1535) Q&A: Delivery Room Predictors, Peritonitis Management, Nutrition (Ep 4)
- [0:00](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=0) Early surgical interventions: G-tubes and PD catheters (Ep 2)
- [3:46](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=226) Renal transplantation technique and complications (Ep 2)
- [6:47](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=407) Discussion: G-tube placement strategy and anatomic considerations (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=0) Pulmonary Survival in Neonates with Bladder Outlet Obstruction (Ep 1)
- [7:31](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=451) Case Presentation and Chronic Kidney Disease Management (Ep 1)
- [19:43](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1183) Dialysis Indications and Transplantation Pathway (Ep 1)
- [26:41](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1601) Clinical Decision-Making and Nutritional Management (Ep 1)
- [0:12](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=12) Introduction and Obstructive Sleep Apnea in Obese Adolescents (Ep 5)
- [7:54](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=474) Esophageal Atresia Long-term Surveillance (Ep 5)
- [12:41](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=761) Gas Embolism During Laparoscopic Pyloromyotomy (Ep 5)
- [24:24](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1464) Thromboelastography in Pediatric Trauma (Ep 5)
- [28:49](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1729) Congenital Diaphragmatic Hernia Readiness Criteria (Ep 5)
- [41:00](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2460) Conservative Management of Spontaneous Pneumothorax (Ep 5)
- [52:33](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3153) Massive Transfusion Protocol in Pediatric Trauma (Ep 5)
- [60:01](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3601) Peritoneal Dialysis Catheter Placement Standards (Ep 5)
- [66:46](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4006) Hemodialysis Access: Fistula versus Catheter (Ep 5)
- [71:04](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4264) Newer Biologic Agents for Inflammatory Bowel Disease (Ep 5)
- [74:49](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4489) Timing of Gonadectomy in Complete Androgen Insensitivity (Ep 5)
- [0:09](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=9) Introduction and Paper Overview (Ep 7)
- [0:54](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=54) Titanic Index for Pectus Excavatum (Ep 7)
- [2:08](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=128) Early Peritoneal Dialysis After Cardiac Surgery (Ep 7)
- [2:59](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=179) Button Battery Ingestion Risk Score (Ep 7)
- [0:00](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=0) Hemodialysis Outcomes After Infant Congenital Heart Surgery (Ep 9)
- [0:00](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=0) Hemodialysis Outcomes After Infant Congenital Heart Surgery (Ep 10)
- [0:00](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=0) Hemodialysis Outcomes After Infant Congenital Heart Surgery (Ep 11)
- [0:00](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=0) Hemodialysis Outcomes After Infant Congenital Heart Surgery (Ep 12)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025" — Jill Knepprath (epidemiological) [Ep 8 · 0:10](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554?t=10)
- "Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence" — Jill Knepprath (epidemiological) [Ep 8 · 0:22](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554?t=22)
- "There was no difference in recurrence rates for open repairs based on surgeon volume" — Jill Knepprath (epidemiological) [Ep 8 · 0:30](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554?t=30)
- "Laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence" — Jill Knepprath (epidemiological) [Ep 8 · 0:35](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554?t=35)
- "The authors recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon" — Jill Knepprath (guideline) [Ep 8 · 0:44](https://library.globalcastmd.com/watch/surgeon-annual-volume-impacts-recurrence-rates-of-pediatric-inguinal-hernia-repairs-a-multi-institutional-study-11554?t=44)
- "Babies that make urine are not likely to need peritoneal dialysis for a little while, but are likely to need it in the future" — Alonso (clinical) [Ep 3 · 0:25](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=25)
- "Peritoneal dialysis catheters should be left alone for a couple of weeks if at all possible after placement" — Alonso (clinical) [Ep 3 · 0:45](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=45)
- "Gastrostomy tube placement is focused along the lesser curvature to preserve the stomach for potential future bladder augmentation" — Alonso (clinical) [Ep 3 · 0:54](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=54)
- "Hemodialysis catheters need to be fairly large caliber and are preferentially placed in the right internal jugular site because it is a straight shot into the atrium" — Alonso (clinical) [Ep 3 · 2:11](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=131)
- "Inguinal and umbilical hernias can develop when babies are on peritoneal dialysis" — Alonso (clinical) [Ep 3 · 2:56](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=176)
- "Hernias are left alone if they are not affecting the mechanics of dialysis and are not particularly symptomatic" — Alonso (clinical) [Ep 3 · 2:56](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=176)
- "The ideal weight for transplantation is around 10 kg if babies are not on peritoneal dialysis" — Alonso (clinical) [Ep 3 · 4:01](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=241)
- "Babies on peritoneal dialysis have a more accommodating abdominal cavity and laxity in the abdominal wall, allowing transplantation closer to 8 kg" — Alonso (clinical) [Ep 3 · 4:01](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=241)
- "All infant recipients have been transplanted with adult donors" — Alonso (clinical) [Ep 3 · 4:17](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=257)
- "An extraperitoneal approach is used for infant renal transplantation with an incision extending to the upper edge close to the costal margin" — Alonso (clinical) [Ep 3 · 4:32](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=272)
- "The biggest complication from a general surgical perspective are wound complications as opposed to vascular complications" — Alonso (clinical) [Ep 3 · 4:59](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=299)
- "Some patients can only be closed at skin level and develop leaks or dehiscence requiring biologic mesh such as derma matrix for closure" — Alonso (clinical) [Ep 3 · 5:08](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=308)
- "In a 13-year follow-up of G tubes in babies, they all migrate up onto the chest" (clinical) [Ep 3 · 7:14](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=434)
- "Insufficient space between the G tube site and PD catheter site can lead to infection problems early on when drainage gets underneath the PD catheter dressing" — Alonso (clinical) [Ep 3 · 7:47](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=467)
- "The standard insertion site for gastrostomy tubes is 2 finger breadths below the costal margin" — Alonso (clinical) [Ep 3 · 8:24](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=504)
- "Gastrostomy tube location must be placed high on the stomach towards the lesser curvature to allow use of a gastric segment for gastric augmentation later in life" — Alonzo (clinical) [Ep 3 · 8:46](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=526)
- "Some babies with posterior urethral valves will need urinary diversion with a vesicostomy placed about 1-2 finger breadths below the umbilicus" — Alonzo (clinical) [Ep 3 · 9:06](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=546)
- "PD catheters can be placed to allow immediate use with lower volumes, though waiting for healing is preferable" — Alonso (clinical) [Ep 3 · 11:20](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=680)
- "Many babies with bladder outlet obstruction have small stomachs, possibly related to minimum amniotic fluid during development" (clinical) [Ep 3 · 11:43](https://library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=703)
- "Dr. Dudike and his team performed a systematic review and meta-analysis on early peritoneal dialysis after pediatric cardiac surgery" — Alex Halpern (clinical) [Ep 6 · 0:14](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=14)
- "Five studies were included in the meta-analysis" — Alex Halpern (clinical) [Ep 6 · 0:19](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=19)
- "Early initiation of peritoneal dialysis was associated with decreased postoperative mortality" — Alex Halpern (clinical) [Ep 6 · 0:24](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=24)
- "Early initiation of peritoneal dialysis shortened duration of mechanical ventilation" — Alex Halpern (clinical) [Ep 6 · 0:30](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=30)
- "Early initiation of peritoneal dialysis shortened length of stay in the ICU" — Alex Halpern (clinical) [Ep 6 · 0:30](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=30)
- "Early initiation of peritoneal dialysis may benefit infants after pediatric cardiac surgery" — Alex Halpern (opinion) [Ep 6 · 0:30](https://library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=30)
- "Pulmonary survival is the primary determinant of outcome in fetal genitourinary disease, more important than renal aspects" — Kingma (opinion) [Ep 4 · 0:28](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=28)
- "If amniotic fluid levels are restored to normal through replacement (shunting or amnioinfusion), likelihood of pulmonary survival increases to approximately 80%" — Kingma (clinical) [Ep 4 · 1:36](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=96)
- "If amniotic fluid levels are not returned to normal, pulmonary outcome is poor" — Kingma (clinical) [Ep 4 · 2:03](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=123)
- "Postnatal factors affecting pulmonary survival include sepsis-related lung injury, nutritional status affecting lung growth, and barotrauma from mechanical ventilation" — Kingma (clinical) [Ep 4 · 3:12](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=192)
- "Pulmonary survivors may have reduced reserve lung function similar to reduced reserve renal function, making them vulnerable to rapid decompensation with injury" — Kingma (clinical) [Ep 4 · 4:27](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=267)
- "Some infants with restored amniotic fluid develop chronic lung disease after delivery, demonstrating abnormal respiratory status despite prenatal intervention" — Kingma (clinical) [Ep 4 · 4:51](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=291)
- "Any urine output, even poor quality urine that is just water without cleared metabolites, is much better than no urine output" — Scober (clinical) [Ep 4 · 9:01](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=541)
- "Babies with obstructive uropathy often have a concentrating defect and produce large volumes of urine" — Scober (clinical) [Ep 4 · 9:58](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=598)
- "These infants with advanced CKD do not typically present with hypertension because of high urine output preventing volume overload and sodium loss from tubular dysfunction" — Scober (clinical) [Ep 4 · 14:33](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=873)
- "Medical management of advanced CKD in infants includes antihypertensives, erythropoietin and iron supplementation, phosphate binders for secondary hyperparathyroidism, citrate for metabolic acidosis, and specialized nutrition" — Scober (clinical) [Ep 4 · 14:33](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=873)
- "Normal infants spend their first year of life developing normal kidney function, with GFR rising from approximately 50 at 1 month to approximately 100 by 1 year" — Scober (clinical) [Ep 4 · 18:25](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1105)
- "Reasonable predictions about kidney function based on creatinine cannot be made until after the first year of life" — Scober (clinical) [Ep 4 · 19:08](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1148)
- "Standard GFR-based CKD staging criteria do not apply to children less than 2 years of age; they can only be categorized as normal, moderately reduced, or very severely reduced age-adjusted GFR" — Scober (guideline) [Ep 4 · 19:36](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1176)
- "Dialysis is indicated for failed CKD management based on growth failure and inability to medically manage hyperkalemia or metabolic acidosis, not based on creatinine cutoff alone" — Scober (clinical) [Ep 4 · 21:37](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1297)
- "Peritoneal dialysis is the technically least difficult modality for providing dialysis in small children" — Scober (clinical) [Ep 4 · 22:22](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1342)
- "Typically one parent stops working when caring for a baby requiring complex CKD management including dialysis, as the baby becomes their full-time job" — Scober (clinical) [Ep 4 · 23:47](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1427)
- "Residual urine output is a major advantage for fluid balance management in dialysis patients" — Scober (clinical) [Ep 4 · 24:11](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1451)
- "Transplantation should be a realistic prospect before placing a patient on chronic dialysis to avoid a never-ending one-way street" — Scober (opinion) [Ep 4 · 24:26](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1466)
- "At this center, the size threshold for safe kidney transplantation is typically 8-10 kg, usually reached in the second year of life" — Scober (clinical) [Ep 4 · 12:29](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=749)
- "Lower urinary tract management includes antibiotic prophylaxis, bladder irrigations, anticholinergics, and catheterization programs guided by urodynamic studies to reduce UTI risk and manage bladder pressure" — Scober (clinical) [Ep 4 · 12:48](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=768)
- "Obstructive uropathy bladders can be very high pressure and can change over time, requiring regular follow-up and adjustment of management" — Scober (clinical) [Ep 4 · 13:46](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=826)
- "For aggressive care, provide whatever respiratory support is needed for the first 3-4 days; if the baby is not stabilizing and improving after that, discuss with parents that the infant is likely not a pulmonary survivor" — Kingma (clinical) [Ep 4 · 26:40](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1600)
- "Infants on peritoneal dialysis who develop sepsis can go from room air to chronic ventilation, raising the question of whether renal transplant remains feasible" — Kingma (clinical) [Ep 4 · 27:39](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1659)
- "Short-term alternatives to peritoneal dialysis in the setting of peritonitis include hemodialysis (requiring blood priming and large catheters in small vessels) and aquaphoresis (ultrafiltration with convective clearance)" — Scober (clinical) [Ep 4 · 28:58](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1738)
- "Temporary hemodialysis catheters in newborns are 8 French size, limited to jugular veins, and prone to movement; tunneled catheters are more stable but likely to cause thrombosis and central stenosis" — Alonso (clinical) [Ep 4 · 30:22](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1822)
- "High urine output babies lose electrolytes including sodium, potassium, and phosphorus, requiring supplementation of electrolytes that older CKD patients are typically told to avoid" — Scober (clinical) [Ep 4 · 31:36](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1896)
- "Formula density is inversely related to urine output; dietitians calculate calorie and protein needs while avoiding dangerously high BUN that would necessitate dialysis" — Scober (clinical) [Ep 4 · 32:06](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1926)
- "It is relatively unusual for these babies to drink spontaneously in amounts sufficient to meet nutritional needs; most require NG tube or gastrostomy tube feeding" — Scober (clinical) [Ep 4 · 32:45](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1965)
- "Breast milk can be incorporated into specialized formulas that meet the baby's specific nutritional needs" — Scober (clinical) [Ep 4 · 33:19](https://library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1999)
- "Babies that make urine are not likely to need peritoneal dialysis for a little while, but are likely to need it in the future" — Lanzo (clinical) [Ep 2 · 0:31](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=31)
- "Peritoneal dialysis catheters should be left alone for a couple of weeks if at all possible" — Lanzo (clinical) [Ep 2 · 0:49](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=49)
- "Gastrostomy tube placement is focused along the lesser curvature to preserve stomach tissue for potential bladder augmentation" — Lanzo (clinical) [Ep 2 · 0:49](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=49)
- "Hemodialysis catheters need to be fairly large caliber and are preferentially placed in the right internal jugular site because it provides a straight shot into the atrium" — Lanzo (clinical) [Ep 2 · 2:18](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=138)
- "Inguinal and umbilical hernias can develop when babies are on peritoneal dialysis" — Lanzo (clinical) [Ep 2 · 3:03](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=183)
- "Hernias are generally left alone if they are not affecting dialysis mechanics or particularly symptomatic" — Lanzo (clinical) [Ep 2 · 3:03](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=183)
- "Ideal weight for transplantation is around 10 kg if infants are not on peritoneal dialysis" — Lanzo (clinical) [Ep 2 · 4:08](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=248)
- "Infants on peritoneal dialysis have a more accommodating abdominal cavity and can be transplanted closer to 8 kg" — Lanzo (clinical) [Ep 2 · 4:08](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=248)
- "All infant recipients have been transplanted with adult donors" — Lanzo (clinical) [Ep 2 · 4:24](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=264)
- "An extraperitoneal approach is used for infant transplantation with an incision extending to the upper edge close to the costal margin" — Lanzo (clinical) [Ep 2 · 4:39](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=279)
- "The biggest complication from a general surgical perspective are wound complications rather than vascular complications" — Lanzo (clinical) [Ep 2 · 5:06](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=306)
- "Some infants can only be closed at the skin level and develop leaks or dehiscence requiring biologic mesh (derma matrix) for closure" — Lanzo (clinical) [Ep 2 · 5:15](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=315)
- "In a 13-year follow-up of G-tubes in babies, they all migrate up onto the chest" (clinical) [Ep 2 · 7:21](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=441)
- "Insufficient space between G-tube site and PD catheter site can lead to infection problems when drainage gets underneath the PD catheter dressing" — Lanzo (clinical) [Ep 2 · 7:54](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=474)
- "G-tube placement high on the stomach toward lesser curvature allows preservation of gastric tissue for potential gastric augmentation later in life" — Alonzo (clinical) [Ep 2 · 8:53](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=533)
- "Some babies will need urinary diversion with a vesicostomy placed about 1-2 finger breadths below the umbilicus" — Alonzo (clinical) [Ep 2 · 9:13](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=553)
- "PD catheters can be placed to allow immediate use with lower volumes, though waiting for healing is preferable" — Lanzo (clinical) [Ep 2 · 11:27](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=687)
- "Many babies with bladder outlet obstruction have small stomachs, possibly related to minimal amniotic fluid during development" (clinical) [Ep 2 · 11:50](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=710)
- "Amnio infusions are performed when patients present for first imaging to assess the baby's capacity to swallow and see if the stomach fills" (clinical) [Ep 2 · 12:30](https://library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=750)
- "The major goal of any fetal intervention for patients with bladder outlet obstruction is to achieve pulmonary survival" — Fong (clinical) [Ep 1 · 0:26](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=26)
- "If amniotic fluid levels are returned to normal through replacement, the likelihood of becoming a pulmonary survivor increases significantly to around 80%" — Paul Kingma (clinical) [Ep 1 · 2:42](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=162)
- "If amniotic fluid levels are not returned to normal, the outcome is poor" — Paul Kingma (clinical) [Ep 1 · 3:08](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=188)
- "Just because an infant survives out of the delivery room does not necessarily mean they are a pulmonary survivor" — Paul Kingma (clinical) [Ep 1 · 3:48](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=228)
- "All patients with bladder outlet obstruction are at extreme risk of sepsis and developing pulmonary lung injury from that" — Paul Kingma (clinical) [Ep 1 · 4:34](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=274)
- "Just because you are a pulmonary survivor does not mean that you're normal from a respiratory standpoint - reserve lung function is not normal" — Paul Kingma (clinical) [Ep 1 · 5:33](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=333)
- "Babies with renal problems who had normal amniotic fluid after replacement can develop chronic lung disease after delivery, evidence that they are not normal from a respiratory standpoint" — Paul Kingma (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=360)
- "Any kind of urine is much better than no urine, even if it's bad urine that is just water and doesn't contain much cleared metabolites" — Jan Scober (clinical) [Ep 1 · 10:32](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=632)
- "Babies with obstructive neuropathy oftentimes have a concentrating defect and they make lots of urine" — Jan Scober (clinical) [Ep 1 · 11:03](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=663)
- "At Cincinnati, the size for safe kidney transplantation is typically somewhere between 8 and 10 kg, putting the timeline probably somewhere into the second year of life" — Jan Scober (guideline) [Ep 1 · 13:24](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=804)
- "Bladder pressure is important not only prenatally but also postnatally" — Jan Scober (clinical) [Ep 1 · 14:21](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=861)
- "Obstructive neuropathy bladders can be very high pressure and can also change over time, so they need to be followed regularly and management may change" — Jan Scober (clinical) [Ep 1 · 14:52](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=892)
- "We don't really see that much hypertension in these babies because they have such high urine output, so they don't tend to be volume overloaded" — Jan Scober (clinical) [Ep 1 · 15:40](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=940)
- "These babies tend to lose sodium because their tubules aren't working, so it's harder for them to retain sodium as another mechanism for hypertension" — Jan Scober (clinical) [Ep 1 · 15:56](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=956)
- "Normal babies with normal urinary tracts and normal kidneys spend their first year of life developing normal kidney function, with normal GFR for a newborn at 1 month of age being about 50, taking a whole year to reach the normal GFR of about 100" — Jan Scober (clinical) [Ep 1 · 19:31](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1171)
- "We can't make reasonable predictions based on clearance and creatinine until somebody has spent that first year of life establishing what their kidney function is going to be" — Jan Scober (clinical) [Ep 1 · 20:14](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1214)
- "GFR criteria for chronic kidney disease staging don't apply to children less than 2 years of age - we can only categorize them into normal, moderately reduced, or very severely reduced age-adjusted GFR" — Jan Scober (guideline) [Ep 1 · 20:42](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1242)
- "Dialysis for small children remains quite challenging but has been improved as far as outcomes and feasibility and should be discussed with families on an individualized basis" — Jan Scober (opinion) [Ep 1 · 21:42](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1302)
- "The creatinine itself doesn't really bother us alone - it's how the baby is doing" — Jan Scober (clinical) [Ep 1 · 22:51](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1371)
- "Failed CKD management requiring dialysis is indicated when the baby stops growing (length, weight, or head circumference) or when we can't medically manage hyperkalemia or metabolic acidosis" — Jan Scober (clinical) [Ep 1 · 22:45](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1365)
- "Peritoneal dialysis is the technically least difficult way to provide dialysis in small children" — Jan Scober (clinical) [Ep 1 · 23:27](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1407)
- "Typically parents will tell us that if they both held jobs prior to having a complicated baby like this, when that started, one of them usually stopped working and the baby became his or her job" — Jan Scober (epidemiological) [Ep 1 · 24:53](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1493)
- "Urine output remains a big plus because it's very hard to manage fluid balance with just dialysis if there's not some residual diuresis" — Jan Scober (clinical) [Ep 1 · 25:17](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1517)
- "It's hard to put somebody on chronic dialysis if there's not some prospect of transplantation down the road" — Jan Scober (opinion) [Ep 1 · 25:31](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1531)
- "A baby who comes out with normal oxygen saturations and never requires oxygen is a great sign, but it's not an absolute sign and unfortunately it's not a frequent sign either" — Paul Kingma (clinical) [Ep 1 · 27:09](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1629)
- "These babies will often require respiratory support of some type in the delivery room, even the ones that will go on to be a pulmonary survivor" — Paul Kingma (clinical) [Ep 1 · 27:19](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1639)
- "If parents want aggressive care, provide whatever support is needed for at least the first 3 to 4 days because there are infants who will require high levels of support and then begin to improve" — Paul Kingma (guideline) [Ep 1 · 27:46](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1666)
- "After the first 3 to 4 days, if the baby is not showing signs of stabilizing and improving, you have to discuss the reality that this infant is likely not a pulmonary survivor" — Paul Kingma (clinical) [Ep 1 · 28:10](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1690)
- "Even if you make it through the first few days, you may have to come back to the pulmonary survival question down the road, most frequently in the settings of sepsis" — Paul Kingma (clinical) [Ep 1 · 28:44](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1724)
- "You have two times when the pulmonary survival question becomes answered: the first 3 to 4 days of life, and then anytime you have an episode of lung injury from sepsis or something like that" — Paul Kingma (clinical) [Ep 1 · 29:14](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1754)
- "Short term, you can try hemodialytic strategies when PD is not available, but that's typically very challenging because you have to blood prime circuits and put very large catheters into relatively very small blood vessels" — Jan Scober (clinical) [Ep 1 · 30:04](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1804)
- "Aquapheresis (ultrafiltration with convective clearance) requires slightly smaller catheters and has been used successfully to maintain an aneuric baby with intraperitoneal problems" — Jan Scober (clinical) [Ep 1 · 30:22](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1822)
- "Not being able to do PD in a small child is a very ominous situation" — Jan Scober (opinion) [Ep 1 · 30:43](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1843)
- "Temporary hemodialysis catheters are difficult in newborns because there's not much catheter design for these small kids, you end up with a lot of catheter that's not intravascular and it moves in and out, and it's an 8 French size catheter limited to the jugular veins" — Maria Alonso (clinical) [Ep 1 · 31:27](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1887)
- "Tunneled hemodialysis catheters are easier to maintain from a movement standpoint but are still very large and likely to cause thrombosis locally and/or stenosis in the central circulation" — Maria Alonso (clinical) [Ep 1 · 31:53](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1913)
- "Nutrition in somebody with urine output is a little easier than in somebody who's oliguric or aneuric because you don't have to concentrate it that much" — Jan Scober (clinical) [Ep 1 · 32:34](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1954)
- "High output babies lose all sorts of electrolytes and we find ourselves supplementing some of these electrolytes like phosphorus that we in older patients preach to avoid" — Jan Scober (clinical) [Ep 1 · 32:49](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1969)
- "The density of the formula is essentially an inverse function of the amount of urine output" — Jan Scober (clinical) [Ep 1 · 33:12](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1992)
- "The inability to provide adequate protein intake may require dialysis in some babies because you can't manage their BUN otherwise" — Jan Scober (clinical) [Ep 1 · 33:23](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2003)
- "It's relatively unusual to expect these babies to drink spontaneously in amounts that will supply adequate nutrition" — Jan Scober (clinical) [Ep 1 · 33:50](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2030)
- "Mothers' breast milk can be incorporated into specialized formulas that meet the baby's specific needs" — Jan Scober (clinical) [Ep 1 · 34:15](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2055)
- "The majority of these kids have an NG tube or a gastrostomy tube and keep that even around transplant because they need to be on a bunch of medicines" — Jan Scober (clinical) [Ep 1 · 34:41](https://library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2081)
- "In the last 40 years, the prevalence of obesity has gone to over 18% of children" — Liz Byerly (epidemiological) [Ep 5 · 6:39](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=399)
- "Kids who are obese and who are getting therapy for DVT require closer monitoring of their enoxaparin levels because they can have altered drug metabolism" — Liz Byerly (clinical) [Ep 5 · 7:24](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=444)
- "ESPGHAN and European counterparts recommend endoscopy following esophageal atresia repair whenever anti-reflux medications are stopped" — Liz Byerly (guideline) [Ep 5 · 10:38](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=638)
- "ESPGHAN recommends screening endoscopy at 10 years of age for esophageal atresia patients, whether or not they're on anti-reflux medications" — Liz Byerly (guideline) [Ep 5 · 11:02](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=662)
- "ESPGHAN recommends screening endoscopy in early adulthood for esophageal atresia patients" — Liz Byerly (guideline) [Ep 5 · 11:10](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=670)
- "Adults with esophageal atresia should have screening endoscopy every 5 to 10 years" — Liz Byerly (guideline) [Ep 5 · 11:15](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=675)
- "A significant number of esophageal atresia patients will have esophageal metaplasia or Barrett's esophagus, and symptoms often do not correlate with pathology" — Liz Byerly (clinical) [Ep 5 · 11:22](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=682)
- "Studies from the Netherlands and Finland showed increased risk of esophageal cancer in esophageal atresia patients" — Liz Byerly (epidemiological) [Ep 5 · 12:00](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=720)
- "Gas embolus during laparoscopy occurs in approximately 28% of cases based on a survey of pediatric surgeons" — Liz Byerly (epidemiological) [Ep 5 · 16:38](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=998)
- "Gas embolus during laparoscopy is thought to occur because the baby has a patent ductus and patent umbilical vein" — Liz Byerly (clinical) [Ep 5 · 16:58](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1018)
- "End-tidal CO2 is the most sensitive detector of gas embolism during laparoscopic surgery" — Liz Byerly (clinical) [Ep 5 · 17:14](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1034)
- "Insufflation tubing contains a significant amount of air with nitrogen, which is not soluble in blood unlike carbon dioxide" — Liz Byerly (clinical) [Ep 5 · 17:33](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1053)
- "Prevention strategies for gas embolus include turning gas on and flushing tubing before connecting to decrease nitrogen delivery" — Liz Byerly (clinical) [Ep 5 · 19:09](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1149)
- "On thromboelastography, R time represents the time for clot to start, and if abnormal, the patient needs FFP" — Liz Byerly (clinical) [Ep 5 · 27:03](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1623)
- "On TEG, alpha angle represents speed of fibrin accumulation, and if abnormal, administer cryoprecipitate" — Liz Byerly (clinical) [Ep 5 · 27:19](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1639)
- "On TEG, maximum amplitude represents maximum clot strength, and if weak with adequate platelet count, patient may need DDAVP" — Liz Byerly (clinical) [Ep 5 · 27:34](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1654)
- "On TEG, LY30 measures lysis at 30 minutes, and if abnormal indicates excessive fibrinolysis requiring aminocaproic acid or tranexamic acid" — Liz Byerly (clinical) [Ep 5 · 28:13](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1693)
- "Canadian CDH Collaborative readiness criteria include normal blood pressure for age, adequate urine output, and reasonable serum lactate reflecting organ perfusion" — Eric Skarsgard (guideline) [Ep 5 · 37:49](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2269)
- "CDH readiness criteria include FiO2 ideally less than 50% and preductal saturation around 90%" — Eric Skarsgard (guideline) [Ep 5 · 38:07](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2287)
- "For CDH, pulmonary artery pressures should be less than systemic pressures before surgery, ideally showing a downward trend" — Eric Skarsgard (guideline) [Ep 5 · 38:20](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2300)
- "Surgery is a stressor on the pulmonary vascular bed in CDH patients" — Eric Skarsgard (clinical) [Ep 5 · 38:34](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2314)
- "For CDH with predominantly right ventricular dysfunction, treatment options include nitric oxide, sildenafil, and PGE1 to maintain ductus patency" — Eric Skarsgard (clinical) [Ep 5 · 39:47](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2387)
- "In CDH, if left ventricle has failed, the baby needs veno-arterial ECMO support" — Eric Skarsgard (clinical) [Ep 5 · 40:28](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2428)
- "Improvements in CDH care are based on what happens outside the operating room, not what happens in the operating room" — Eric Skarsgard (opinion) [Ep 5 · 35:50](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2150)
- "In spontaneous pneumothorax trial, conservative management showed roughly equivalent lung re-expansion by 8 weeks compared to intervention" — Eric Skarsgard (clinical) [Ep 5 · 50:13](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3013)
- "Conservative management of spontaneous pneumothorax showed threefold increase in adverse events in the interventional group" — Eric Skarsgard (clinical) [Ep 5 · 50:22](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3022)
- "Conservative management of spontaneous pneumothorax showed threefold increase in length of stay in interventional group" — Eric Skarsgard (clinical) [Ep 5 · 50:41](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3041)
- "Conservative management of spontaneous pneumothorax showed twofold increase in twelve-month recurrence rates" — Eric Skarsgard (clinical) [Ep 5 · 50:50](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3050)
- "There was a 15% crossover rate in the conservative pneumothorax group, meaning patients progressed and needed intervention" — Eric Skarsgard (clinical) [Ep 5 · 49:54](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2994)
- "ATLS 10th edition guidelines limit crystalloid to 20 cc per kilo in pediatric trauma" — Eric Skarsgard (guideline) [Ep 5 · 56:23](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3383)
- "Excessive crystalloid worsens dilutional coagulopathy and increases metabolic acidosis in trauma" — Eric Skarsgard (clinical) [Ep 5 · 56:37](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3397)
- "Early balanced blood product resuscitation (red cells, platelets, plasma) results in less total blood product use and improved mortality and morbidity outcomes" — Eric Skarsgard (clinical) [Ep 5 · 57:44](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3464)
- "Military study clearly shows survival advantage from TXA use in trauma patients" — Eric Skarsgard (clinical) [Ep 5 · 58:32](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3512)
- "There is no evidence for intentional hypotensive resuscitation as a strategy in pediatric trauma" — Eric Skarsgard (clinical) [Ep 5 · 58:51](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3531)
- "SCOPE Collaborative evaluates three elements for peritoneal dialysis catheters: preoperative antibiotics, downward or lateral exit site placement, and no suture at exit site" — Todd (guideline) [Ep 5 · 63:46](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3826)
- "Failure rates for hemodialysis catheters are approximately 45% within two months" — Todd (epidemiological) [Ep 5 · 63:07](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3787)
- "Failure rates for peritoneal dialysis catheters are 30 to 50%" — Todd (epidemiological) [Ep 5 · 63:07](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3787)
- "Half-life of even a living donor kidney is only about 23 to 24 years" — Eric Skarsgard (clinical) [Ep 5 · 69:16](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4156)
- "Infliximab (Remicade) is the best agent for Crohn's disease, but about 10% of patients will no longer respond per year" — Todd (clinical) [Ep 5 · 73:07](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4387)
- "Vedolizumab (Entyvio) is a monoclonal antibody targeted at gut epithelium with a great safety profile" — Todd (clinical) [Ep 5 · 73:55](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4435)
- "In a review of 64 children who failed anti-TNF therapy, 25 reached steroid-free remission with vedolizumab" — Todd (clinical) [Ep 5 · 74:06](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4446)
- "Early adult studies show complications after surgery are equivalent between Remicade and Entyvio" — Todd (clinical) [Ep 5 · 74:31](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4471)
- "The risk of cancer in complete androgen insensitivity is probably lower than previously thought, closer to 1 to 2% rather than 2 to 5%" — Todd (clinical) [Ep 5 · 78:55](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4735)
- "Patients with complete androgen insensitivity report feeling abnormal after gonadectomy even with estrogen replacement because testes are a source of estrogen and testosterone converted peripherally" — Todd (clinical) [Ep 5 · 79:12](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4752)
- "Older women on estrogens for prolonged periods after gonadectomy have increased cardiovascular risk" — Todd (clinical) [Ep 5 · 79:36](https://library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4776)
- "The Haller index and correction index are currently the primary indices used for pectus excavatum and tell us about the severity of the deformity" — Ellen Encisco (clinical) [Ep 7 · 1:12](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=72)
- "The Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans" — Ellen Encisco (clinical) [Ep 7 · 1:26](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=86)
- "There is a weak correlation between the Titanic index and the other indices (Haller and correction indices)" — Ellen Encisco (clinical) [Ep 7 · 1:44](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=104)
- "The Titanic index might be more helpful for determining how many bars a patient will need for pectus excavatum repair" — Ellen Encisco (clinical) [Ep 7 · 1:44](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=104)
- "A Titanic index threshold of 66.5% was established, with patients above this threshold probably needing more than 2 bars for repair" — Ellen Encisco (clinical) [Ep 7 · 1:55](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=115)
- "The meta-analysis included 5 studies on early peritoneal dialysis after pediatric cardiac surgery" — Alex Halpern (epidemiological) [Ep 7 · 2:32](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=152)
- "Early initiation of peritoneal dialysis was associated with decreased post-operative mortality in infants after cardiac surgery" — Alex Halpern (clinical) [Ep 7 · 2:35](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=155)
- "Early initiation of peritoneal dialysis shortened duration of mechanical ventilation after pediatric cardiac surgery" — Alex Halpern (clinical) [Ep 7 · 2:41](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=161)
- "Early initiation of peritoneal dialysis shortened length of stay in the ICU after pediatric cardiac surgery" — Alex Halpern (clinical) [Ep 7 · 2:41](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=161)
- "The button battery study was a retrospective study done at Boston Children's Hospital from 2008 to 2021" — Cecilia Gigena (epidemiological) [Ep 7 · 3:16](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=196)
- "The button battery study analyzed 143 patients, of whom 24 had severe outcomes" — Cecilia Gigena (epidemiological) [Ep 7 · 3:30](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=210)
- "Location of the button battery in the esophagus is an independent predictor for severe outcomes" — Cecilia Gigena (clinical) [Ep 7 · 3:37](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=217)
- "A button battery larger than 2 centimeters is an independent predictor for severe outcomes" — Cecilia Gigena (clinical) [Ep 7 · 3:45](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=225)
- "Having symptoms at presentation is an independent predictor for severe outcomes in button battery ingestion" — Cecilia Gigena (clinical) [Ep 7 · 3:49](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=229)
- "1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 9 · 0:07](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=7)
- "For infants that needed hemodialysis after congenital heart surgery, one-year survival was 46%" — Lizzie Lee (epidemiological) [Ep 9 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=14)
- "For infants that did not need hemodialysis after congenital heart surgery, one-year survival was 94%" — Lizzie Lee (epidemiological) [Ep 9 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=14)
- "Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis" — Lizzie Lee (clinical) [Ep 9 · 0:23](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=23)
- "Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 9 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=33)
- "Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 9 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=33)
- "Dialysis after infant heart surgery is rare" — Lizzie Lee (epidemiological) [Ep 9 · 0:39](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=39)
- "Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis" — Lizzie Lee (opinion) [Ep 9 · 0:44](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-th-12114?t=44)
- "1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 10 · 0:07](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=7)
- "For infants needing hemodialysis after congenital heart surgery, one-year survival was 46%" — Lizzie Lee (clinical) [Ep 10 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=14)
- "For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94%" — Lizzie Lee (clinical) [Ep 10 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=14)
- "Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis" — Lizzie Lee (clinical) [Ep 10 · 0:23](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=23)
- "Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery" — Lizzie Lee (clinical) [Ep 10 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=33)
- "Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery" — Lizzie Lee (clinical) [Ep 10 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=33)
- "Dialysis after infant heart surgery is rare" — Lizzie Lee (epidemiological) [Ep 10 · 0:39](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=39)
- "Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis" — Lizzie Lee (opinion) [Ep 10 · 0:44](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12117?t=44)
- "1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 11 · 0:07](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=7)
- "For infants needing hemodialysis after congenital heart surgery, one-year survival was 46%" — Lizzie Lee (clinical) [Ep 11 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=14)
- "For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94%" — Lizzie Lee (clinical) [Ep 11 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=14)
- "Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis" — Lizzie Lee (clinical) [Ep 11 · 0:23](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=23)
- "Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery" — Lizzie Lee (clinical) [Ep 11 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=33)
- "Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery" — Lizzie Lee (clinical) [Ep 11 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=33)
- "Dialysis after infant heart surgery is rare" — Lizzie Lee (epidemiological) [Ep 11 · 0:39](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=39)
- "Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis" — Lizzie Lee (opinion) [Ep 11 · 0:44](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-in-the-12127?t=44)
- "1% of infants develop severe acute kidney injury requiring dialysis after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 12 · 0:07](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=7)
- "One-year survival for infants requiring hemodialysis after congenital heart surgery is 46%" — Lizzie Lee (epidemiological) [Ep 12 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=14)
- "One-year survival for infants not requiring hemodialysis after congenital heart surgery is 94%" — Lizzie Lee (epidemiological) [Ep 12 · 0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=14)
- "Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis" — Lizzie Lee (clinical) [Ep 12 · 0:23](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=23)
- "Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 12 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=33)
- "Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 12 · 0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=33)
- "Dialysis after infant heart surgery is rare" — Lizzie Lee (epidemiological) [Ep 12 · 0:39](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=39)
- "Outcomes for infants requiring dialysis after heart surgery may improve when treated at centers with more experience in using dialysis" — Lizzie Lee (clinical) [Ep 12 · 0:44](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=44)

## Changelog
- Aug 31: 11 doctors auto-found from episode dossiers
- Aug 30: 11 doctors auto-found from episode dossiers
- Aug 30: 11 doctors auto-found from episode dossiers
- Aug 29: 11 doctors auto-found from episode dossiers
- Aug 29: 11 doctors auto-found from episode dossiers
- Aug 29: Collection generated from campaign corpus: 12 items, 12 dossiers, summaries for 4 audience(s)
- Aug 29: Collection reviewed and published
- Aug 29: Collection generated from campaign corpus: 12 items, 12 dossiers, summaries for 1 audience(s)
- Aug 29: Collection generated from campaign corpus: 12 items, 12 dossiers, summaries for 1 audience(s)
- Aug 29: Collection generated from campaign corpus: 12 items, 12 dossiers, summaries for 2 audience(s)

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Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://library.globalcastmd.com/ai