Collection
Respiratory Support and Airway Management
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Diaphragm pacing as alternative to mechanical ventilation in pediatric respiratory failure
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Dr. P. Ben Ham III discusses diaphragm pacing as an intervention for children with respiratory failure, aiming to help them wean off mechanical ventilation. The video covers indications such as central hypoventilation, spinal cord injury, A
podcast1:44 · Nov 2026
Tracheobronchopexy was performed on thoracic trachea alone in over half the patients but had to extend onto the bronchi in 40% — George W. Holcomb III, Journal of Pediatric Surgery quarterly review: tracheobronchopexy outcomes, surgical outreach access, and gastrostomy practice variation · 2:44
Journal of Pediatric Surgery quarterly review: tracheobronchopexy outcomes, surgical outreach access, and gastrostomy practice variation
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We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the second quarter of 2025, April, May and June issues. This time we're talking to editors Drs. George Ho
podcast16:35 · Nov 2026
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Journal of Pediatric Surgery quarterly review: tracheobronchopexy outcomes, surgical outreach access, and gastrostomy practice variation
Esophageal atresia repair patients can experience severe airway collapse leaving them ventilator dependent or suffering repeated cyanotic spells
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position1:41 ↗
Most pediatric surgeons won't see 10 patients with postoperative airway collapse spells in their career, and many wouldn't see 5
epidemiologicalGeorge W. Holcomb III2:21 ↗
The series included 80 children who underwent tracheobronchopexy from two high volume centers, most with type C esophageal atresia
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position2:08 ↗
Dynamic bronchoscopy showed complete airway collapse in 90% of patients
clinicalGeorge W. Holcomb III2:34 ↗
Three-quarters of procedures used a posterior approach
clinicalGeorge W. Holcomb III2:40 ↗
Tracheobronchopexy was performed on thoracic trachea alone in over half the patients but had to extend onto the bronchi in 40%
clinicalGeorge W. Holcomb III2:44 ↗
94% of patients avoided tracheostomy with a mortality rate of 5%
clinicalGeorge W. Holcomb III2:57 ↗
The procedure significantly reduced pressure ventilation and ventilator dependence
clinicalGeorge W. Holcomb III2:57 ↗
These results reflect expertise of centers who have done numerous or hundreds of these type procedures
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position3:09 ↗
Canada is the second largest country in the world geographically but population-wise smaller than California
epidemiological5:28 ↗
The majority of Canada's population lives within 200 kilometers of the US border
epidemiological5:38 ↗
In the Canadian context, outreach is defined as pediatric surgery service provided outside the main pediatric surgery tertiary center, not necessarily tied to geographic distance
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position5:55 ↗
Outreach services were present in only 7 out of 10 provinces and only 8 out of 18 children's hospitals (44%) provided outreach services
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position6:43 ↗
A significant number of outreach services are located within 50 kilometers of a children's hospital, leaving vast regions without access
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position6:57 ↗
Many families must travel hundreds or even thousands of kilometers for basic procedures
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position7:08 ↗
The study did not address surgical care provided to children in remote communities by non-pediatric surgical specialists
clinical7:15 ↗
In most places in Canada, no one would transfer a 16 or 17 year old with appendicitis to a children's hospital for surgery as they are physiologically adult and do not need pediatric surgeon expertise
opinion7:36 ↗
Access to surgical care for children in Canada has been in need of improvement for decades
opinion7:51 ↗
It is a misconception that the Canadian healthcare system ensures timely care; children wait for surgery beyond their wait time target
clinical8:01 ↗
Newfoundland and Labrador has the best outreach setup with only two pediatric surgeons but outreach clinics all over the province, serving as a model
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position8:16 ↗
Newfoundland and Labrador's population is really rural and spread out, and weather can make accessing care impossible or financially devastating
clinical8:31 ↗
The study used RGIS geospatial mapping to identify distribution of outreach sites nationally across Canada
clinical8:50 ↗
There are measurable costs of living remote to accessible high quality care in terms of time required to be seen and clinical outcomes
clinical9:01 ↗
Gastrostomy tube insertion is one of the most common operations performed in pediatric surgery
epidemiological11:19 ↗
Until now there wasn't a great national clinical sample of data capturing both care processes and outcomes specific to G tubes
clinical11:19 ↗
The children's surgery team within the American College of Surgeons started collecting G tube specific variables through NSQIP
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position11:35 ↗
The study used 71 NSQIP pediatric hospitals that participated in the G-tube pilot starting in 2023
clinical11:47 ↗
In the NSQIP database, 5% of all pediatric procedures were G tube
epidemiologicalSean Kunisaki11:56 ↗
The study analyzed 4,612 G tube placements from one year of data in 2023
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position12:38 ↗
77% of G tube cases were first-time G tubes as opposed to redos
epidemiological12:46 ↗
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