Bhargava Muliudi

117 timestamped statements across 3 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Featured diaries

▶ Ep 21 · 4:41
At Cincinnati Children's, we follow a protocol published by the Children's Mercy Group in Kansas City that takes the guesswork out of how many bonuses to give and how frequently you should draw labs.
quote · Etiologies (Gastroschisis/NEC/Atresia/Volvulus)
▶ Ep 30 · 4:41
At Cincinnati Children's, we follow a protocol published by the Children's Mercy Group in Kansas City that takes the guesswork out of how many bonuses to give and how frequently you should draw labs.
quote · Intestinal Rehab
▶ Ep 27 · 4:41
At Cincinnati Children's, we follow a protocol published by the Children's Mercy Group in Kansas City that takes the guesswork out of how many bonuses to give and how frequently you should draw labs.
quote · Single Ventricle / HLHS
▶ Ep 21 · 2:55
Easy way to remember this is to remember the value of pi as 314, 3 millimeters thick and 4 millimeters long, and anything above this is diagnostic.
quote · Etiologies (Gastroschisis/NEC/Atresia/Volvulus)
▶ Ep 30 · 2:55
Easy way to remember this is to remember the value of pi as 314, 3 millimeters thick and 4 millimeters long, and anything above this is diagnostic.
quote · Intestinal Rehab
▶ Ep 27 · 2:55
Easy way to remember this is to remember the value of pi as 314, 3 millimeters thick and 4 millimeters long, and anything above this is diagnostic.
quote · Single Ventricle / HLHS

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Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 39 entries

Pyloric Stenosis

▶ Ep 21 · 0:31
quote Pyloric stenosis is hypertrophy and hyperplasia of the inner circular layer with associated mucosal hypertrophy. ↗
▶ Ep 21 · 0:31
clinical Pyloric stenosis is hypertrophy and hyperplasia of the inner circular layer with associated mucosal hypertrophy ↗
▶ Ep 21 · 0:37
clinical Pyloric stenosis leads to gastric outlet obstruction in infants between 2 to 10 weeks of age ↗
▶ Ep 21 · 0:46
epidemiological Pyloric stenosis is more common in males ↗
▶ Ep 21 · 0:49
epidemiological There is increased risk for first born infants with a positive family history ↗
▶ Ep 21 · 1:04
clinical Patients with pyloric stenosis typically present with non-bilious vomiting, usually seen between 2 to 10 weeks of life ↗
▶ Ep 21 · 1:12
clinical Infants with pyloric stenosis are otherwise well appearing and hungry after vomiting ↗
▶ Ep 21 · 1:16
clinical Emesis in pyloric stenosis will progress until it is projectile ↗
▶ Ep 21 · 1:24
clinical Hyperbilirubinemia can occur in up to 14% of patients with pyloric stenosis due to downregulation of hepatic enzymes associated with starvation ↗
▶ Ep 21 · 2:00
guideline Bilious emesis should always be worked up to rule out intestinal malrotation with midgut volvulus ↗
▶ Ep 21 · 2:50
clinical Ultrasound is the gold standard for diagnosing pyloric stenosis ↗
▶ Ep 21 · 2:55
clinical Pyloric stenosis is diagnosed on ultrasound when pyloric muscle is 3 millimeters thick and 14 millimeters long or greater ↗
▶ Ep 21 · 2:55
quote Easy way to remember this is to remember the value of pi as 314, 3 millimeters thick and 4 millimeters long, and anything above this is diagnostic. ↗
▶ Ep 21 · 3:19
clinical The classic electrolyte abnormality in pyloric stenosis is hypochloremic, hypokalemic, metabolic alkalosis ↗
▶ Ep 21 · 3:19
quote The classic electrolyte abnormality is a hypochloremic, hypokalemic, metabolic alkalosis. ↗
▶ Ep 21 · 3:29
clinical Prolonged gastric outlet obstruction leads to persistent vomiting and loss of hydrochloric acid, which leads to hypochloremia and loss of protons leading to metabolic alkalosis ↗
▶ Ep 21 · 3:41
clinical The kidneys compensate for dehydration by increasing the activity of the sodium potassium pump to retain fluid, leading to urinary excretion of potassium to preserve sodium and water ↗
▶ Ep 21 · 3:56
clinical In later stages of pyloric stenosis, excretion of protons leads to paradoxical aciduria, which further worsens metabolic alkalosis ↗
▶ Ep 21 · 4:17
guideline In the US, pyloromyotomy is the standard of care for pyloric stenosis ↗
▶ Ep 21 · 4:22
clinical In some countries, atropine is used as a non-surgical option for pyloric stenosis, with a success rate of about 60 to 90% ↗
▶ Ep 21 · 4:41
quote At Cincinnati Children's, we follow a protocol published by the Children's Mercy Group in Kansas City that takes the guesswork out of how many bonuses to give and how frequently you should draw labs. ↗
▶ Ep 21 · 4:41
guideline Cincinnati Children's follows a resuscitation protocol published by the Children's Mercy Group in Kansas City for pyloric stenosis ↗
▶ Ep 21 · 5:01
guideline If chloride is less than 85, give 3 boluses separated by an hour and then recheck labs ↗
▶ Ep 21 · 5:10
guideline If chloride is between 85 and 97, give two boluses ↗
▶ Ep 21 · 5:15
guideline If chloride is greater than 97, give 1 bolus ↗
▶ Ep 21 · 5:24
guideline If bicarbonate is greater than 40, give 3 boluses ↗
▶ Ep 21 · 5:29
guideline If bicarbonate is greater than or equal to 33, give 2 boluses ↗
▶ Ep 21 · 5:48
guideline Prior to going to the operating room, serum chloride must be corrected to greater than 100 and bicarbonate to less than 30 ↗
▶ Ep 21 · 7:00
clinical The proximal edge of the pylorus can be easily identified as the antrum transitions to a thick pylorus ↗
▶ Ep 21 · 7:07
clinical The distal extent of the pyloromyotomy is generally to the crossing vein of Mayo or the white line, which marks the pyloroduodenal junction ↗
▶ Ep 21 · 8:18
clinical After the pyloromyotomy is completed, the submucosa should bulge into the myotomy site ↗
▶ Ep 21 · 8:25
clinical After adequate pyloromyotomy, each side of the pylorus should move independently ↗
▶ Ep 21 · 8:42
clinical Complications from pyloromyotomy include incomplete myotomy, mucosal perforation, aspiration, wound infection, and incisional hernias ↗
▶ Ep 21 · 8:52
clinical There is a slight increased risk of incomplete myotomy and perforation with a laparoscopic approach, but the overall low incidence of complications decreases the clinical significance of the differences between the two approaches ↗
▶ Ep 21 · 9:17
clinical For mucosal perforation during pyloromyotomy, you can close the mucosa using a low profile needle and suture like Vicryl on a TF needle, or perform a full thickness repair and redo a myotomy about 180 degrees from the first one, usually on the posterior wall ↗
▶ Ep 21 · 10:05
clinical Most infants can be fed immediately after pyloromyotomy ↗
▶ Ep 21 · 10:13
clinical Evidence supports ad-lib feeds after pyloromyotomy; once the infant is alert and awake, these infants achieve full feeds sooner with no increase in readmission rates ↗
▶ Ep 21 · 10:32
clinical Small episodes of emesis after pyloromyotomy are almost to be expected as the stomach recovers from days to weeks of progressive dilation ↗
▶ Ep 21 · 10:44
clinical Odds of emesis is slightly higher in early and ad-lib feedings compared to gradual or delayed feedings, but the length of stay for ad-lib feedings is much shorter ↗
Intestinal Rehab 39 entries

Pyloric Stenosis

▶ Ep 30 · 0:31
clinical Pyloric stenosis is hypertrophy and hyperplasia of the inner circular layer with associated mucosal hypertrophy ↗
▶ Ep 30 · 0:31
quote Pyloric stenosis is hypertrophy and hyperplasia of the inner circular layer with associated mucosal hypertrophy. ↗
▶ Ep 30 · 0:37
clinical Pyloric stenosis leads to gastric outlet obstruction in infants between 2 to 10 weeks of age ↗
▶ Ep 30 · 0:46
epidemiological Pyloric stenosis is more common in males ↗
▶ Ep 30 · 0:49
epidemiological There is increased risk for first born infants with a positive family history ↗
▶ Ep 30 · 1:04
clinical Patients with pyloric stenosis typically present with non-bilious vomiting, usually seen between 2 to 10 weeks of life ↗
▶ Ep 30 · 1:12
clinical Infants with pyloric stenosis are otherwise well appearing and hungry after vomiting ↗
▶ Ep 30 · 1:16
clinical Emesis in pyloric stenosis will progress until it is projectile ↗
▶ Ep 30 · 1:24
clinical Hyperbilirubinemia can occur in up to 14% of patients with pyloric stenosis due to downregulation of hepatic enzymes associated with starvation ↗
▶ Ep 30 · 2:00
guideline Bilious emesis should always be worked up to rule out intestinal malrotation with midgut volvulus ↗
▶ Ep 30 · 2:50
clinical Ultrasound is the gold standard for diagnosing pyloric stenosis ↗
▶ Ep 30 · 2:55
clinical Pyloric stenosis is diagnosed on ultrasound when pyloric muscle is 3 millimeters thick and 14 millimeters long or greater ↗
▶ Ep 30 · 2:55
quote Easy way to remember this is to remember the value of pi as 314, 3 millimeters thick and 4 millimeters long, and anything above this is diagnostic. ↗
▶ Ep 30 · 3:19
quote The classic electrolyte abnormality is a hypochloremic, hypokalemic, metabolic alkalosis. ↗
▶ Ep 30 · 3:19
clinical The classic electrolyte abnormality in pyloric stenosis is hypochloremic, hypokalemic, metabolic alkalosis ↗
▶ Ep 30 · 3:29
clinical Prolonged gastric outlet obstruction leads to persistent vomiting and loss of hydrochloric acid, which leads to hypochloremia and loss of protons leading to metabolic alkalosis ↗
▶ Ep 30 · 3:41
clinical The kidneys compensate for dehydration by increasing the activity of the sodium potassium pump to retain fluid, leading to urinary excretion of potassium to preserve sodium and water ↗
▶ Ep 30 · 3:56
clinical In later stages of pyloric stenosis, excretion of protons leads to paradoxical aciduria, which further worsens metabolic alkalosis ↗
▶ Ep 30 · 4:17
guideline In the US, pyloromyotomy is the standard of care for pyloric stenosis ↗
▶ Ep 30 · 4:22
clinical In some countries, atropine is used as a non-surgical option for pyloric stenosis, with a success rate of about 60 to 90% ↗
▶ Ep 30 · 4:41
guideline Cincinnati Children's follows a resuscitation protocol published by the Children's Mercy Group in Kansas City for pyloric stenosis ↗
▶ Ep 30 · 4:41
quote At Cincinnati Children's, we follow a protocol published by the Children's Mercy Group in Kansas City that takes the guesswork out of how many bonuses to give and how frequently you should draw labs. ↗
▶ Ep 30 · 5:01
guideline If chloride is less than 85, give 3 boluses separated by an hour and then recheck labs ↗
▶ Ep 30 · 5:10
guideline If chloride is between 85 and 97, give two boluses ↗
▶ Ep 30 · 5:15
guideline If chloride is greater than 97, give 1 bolus ↗
▶ Ep 30 · 5:24
guideline If bicarbonate is greater than 40, give 3 boluses ↗
▶ Ep 30 · 5:29
guideline If bicarbonate is greater than or equal to 33, give 2 boluses ↗
▶ Ep 30 · 5:48
guideline Prior to going to the operating room, serum chloride must be corrected to greater than 100 and bicarbonate to less than 30 ↗
▶ Ep 30 · 7:00
clinical The proximal edge of the pylorus can be easily identified as the antrum transitions to a thick pylorus ↗
▶ Ep 30 · 7:07
clinical The distal extent of the pyloromyotomy is generally to the crossing vein of Mayo or the white line, which marks the pyloroduodenal junction ↗
▶ Ep 30 · 8:18
clinical After the pyloromyotomy is completed, the submucosa should bulge into the myotomy site ↗
▶ Ep 30 · 8:25
clinical After adequate pyloromyotomy, each side of the pylorus should move independently ↗
▶ Ep 30 · 8:42
clinical Complications from pyloromyotomy include incomplete myotomy, mucosal perforation, aspiration, wound infection, and incisional hernias ↗
▶ Ep 30 · 8:52
clinical There is a slight increased risk of incomplete myotomy and perforation with a laparoscopic approach, but the overall low incidence of complications decreases the clinical significance of the differences between the two approaches ↗
▶ Ep 30 · 9:17
clinical For mucosal perforation during pyloromyotomy, you can close the mucosa using a low profile needle and suture like Vicryl on a TF needle, or perform a full thickness repair and redo a myotomy about 180 degrees from the first one, usually on the posterior wall ↗
▶ Ep 30 · 10:05
clinical Most infants can be fed immediately after pyloromyotomy ↗
▶ Ep 30 · 10:13
clinical Evidence supports ad-lib feeds after pyloromyotomy; once the infant is alert and awake, these infants achieve full feeds sooner with no increase in readmission rates ↗
▶ Ep 30 · 10:32
clinical Small episodes of emesis after pyloromyotomy are almost to be expected as the stomach recovers from days to weeks of progressive dilation ↗
▶ Ep 30 · 10:44
clinical Odds of emesis is slightly higher in early and ad-lib feedings compared to gradual or delayed feedings, but the length of stay for ad-lib feedings is much shorter ↗
Single Ventricle / HLHS 39 entries

Pyloric Stenosis

▶ Ep 27 · 0:31
clinical Pyloric stenosis is hypertrophy and hyperplasia of the inner circular layer with associated mucosal hypertrophy ↗
▶ Ep 27 · 0:31
quote Pyloric stenosis is hypertrophy and hyperplasia of the inner circular layer with associated mucosal hypertrophy. ↗
▶ Ep 27 · 0:37
clinical Pyloric stenosis leads to gastric outlet obstruction in infants between 2 to 10 weeks of age ↗
▶ Ep 27 · 0:46
epidemiological Pyloric stenosis is more common in males ↗
▶ Ep 27 · 0:49
epidemiological There is increased risk for first born infants with a positive family history ↗
▶ Ep 27 · 1:04
clinical Patients with pyloric stenosis typically present with non-bilious vomiting, usually seen between 2 to 10 weeks of life ↗
▶ Ep 27 · 1:12
clinical Infants with pyloric stenosis are otherwise well appearing and hungry after vomiting ↗
▶ Ep 27 · 1:16
clinical Emesis in pyloric stenosis will progress until it is projectile ↗
▶ Ep 27 · 1:24
clinical Hyperbilirubinemia can occur in up to 14% of patients with pyloric stenosis due to downregulation of hepatic enzymes associated with starvation ↗
▶ Ep 27 · 2:00
guideline Bilious emesis should always be worked up to rule out intestinal malrotation with midgut volvulus ↗
▶ Ep 27 · 2:50
clinical Ultrasound is the gold standard for diagnosing pyloric stenosis ↗
▶ Ep 27 · 2:55
quote Easy way to remember this is to remember the value of pi as 314, 3 millimeters thick and 4 millimeters long, and anything above this is diagnostic. ↗
▶ Ep 27 · 2:55
clinical Pyloric stenosis is diagnosed on ultrasound when pyloric muscle is 3 millimeters thick and 14 millimeters long or greater ↗
▶ Ep 27 · 3:19
clinical The classic electrolyte abnormality in pyloric stenosis is hypochloremic, hypokalemic, metabolic alkalosis ↗
▶ Ep 27 · 3:19
quote The classic electrolyte abnormality is a hypochloremic, hypokalemic, metabolic alkalosis. ↗
▶ Ep 27 · 3:29
clinical Prolonged gastric outlet obstruction leads to persistent vomiting and loss of hydrochloric acid, which leads to hypochloremia and loss of protons leading to metabolic alkalosis ↗
▶ Ep 27 · 3:41
clinical The kidneys compensate for dehydration by increasing the activity of the sodium potassium pump to retain fluid, leading to urinary excretion of potassium to preserve sodium and water ↗
▶ Ep 27 · 3:56
clinical In later stages of pyloric stenosis, excretion of protons leads to paradoxical aciduria, which further worsens metabolic alkalosis ↗
▶ Ep 27 · 4:17
guideline In the US, pyloromyotomy is the standard of care for pyloric stenosis ↗
▶ Ep 27 · 4:22
clinical In some countries, atropine is used as a non-surgical option for pyloric stenosis, with a success rate of about 60 to 90% ↗
▶ Ep 27 · 4:41
guideline Cincinnati Children's follows a resuscitation protocol published by the Children's Mercy Group in Kansas City for pyloric stenosis ↗
▶ Ep 27 · 4:41
quote At Cincinnati Children's, we follow a protocol published by the Children's Mercy Group in Kansas City that takes the guesswork out of how many bonuses to give and how frequently you should draw labs. ↗
▶ Ep 27 · 5:01
guideline If chloride is less than 85, give 3 boluses separated by an hour and then recheck labs ↗
▶ Ep 27 · 5:10
guideline If chloride is between 85 and 97, give two boluses ↗
▶ Ep 27 · 5:15
guideline If chloride is greater than 97, give 1 bolus ↗
▶ Ep 27 · 5:24
guideline If bicarbonate is greater than 40, give 3 boluses ↗
▶ Ep 27 · 5:29
guideline If bicarbonate is greater than or equal to 33, give 2 boluses ↗
▶ Ep 27 · 5:48
guideline Prior to going to the operating room, serum chloride must be corrected to greater than 100 and bicarbonate to less than 30 ↗
▶ Ep 27 · 7:00
clinical The proximal edge of the pylorus can be easily identified as the antrum transitions to a thick pylorus ↗
▶ Ep 27 · 7:07
clinical The distal extent of the pyloromyotomy is generally to the crossing vein of Mayo or the white line, which marks the pyloroduodenal junction ↗
▶ Ep 27 · 8:18
clinical After the pyloromyotomy is completed, the submucosa should bulge into the myotomy site ↗
▶ Ep 27 · 8:25
clinical After adequate pyloromyotomy, each side of the pylorus should move independently ↗
▶ Ep 27 · 8:42
clinical Complications from pyloromyotomy include incomplete myotomy, mucosal perforation, aspiration, wound infection, and incisional hernias ↗
▶ Ep 27 · 8:52
clinical There is a slight increased risk of incomplete myotomy and perforation with a laparoscopic approach, but the overall low incidence of complications decreases the clinical significance of the differences between the two approaches ↗
▶ Ep 27 · 9:17
clinical For mucosal perforation during pyloromyotomy, you can close the mucosa using a low profile needle and suture like Vicryl on a TF needle, or perform a full thickness repair and redo a myotomy about 180 degrees from the first one, usually on the posterior wall ↗
▶ Ep 27 · 10:05
clinical Most infants can be fed immediately after pyloromyotomy ↗
▶ Ep 27 · 10:13
clinical Evidence supports ad-lib feeds after pyloromyotomy; once the infant is alert and awake, these infants achieve full feeds sooner with no increase in readmission rates ↗
▶ Ep 27 · 10:32
clinical Small episodes of emesis after pyloromyotomy are almost to be expected as the stomach recovers from days to weeks of progressive dilation ↗
▶ Ep 27 · 10:44
clinical Odds of emesis is slightly higher in early and ad-lib feedings compared to gradual or delayed feedings, but the length of stay for ad-lib feedings is much shorter ↗