# Peritoneal Dialysis Access — GCMD Library living collection

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

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

Updated: n/a · 11 episodes · 165 cited statements

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

### Surgical Management
- [Renal transplantation: Cincinnati Fetal Center](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623) — video · 13:51 · [machine version](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623.md)
- [Renal transplantation: Fetal Genitourinary Disease 2015](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915) — video · 13:44 · [machine version](https://qa.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://qa.library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220) — video · 0:47 · [machine version](https://qa.library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220.md)
- [Quick Literature Updates Episode 13](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638) — video · 4:12 · [machine version](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638.md)
- [Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in th](https://qa.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://qa.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://qa.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://qa.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://qa.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://qa.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://qa.library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128) — video · 0:53 · [machine version](https://qa.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://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998) — video · 83:26 · [machine version](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998.md)

## Chapters
- [0:00](https://qa.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://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=451) Managing Advanced Chronic Kidney Disease in Fetal Center Graduates (Ep 1)
- [26:41](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1601) Clinical Decision-Making and Nutritional Management (Ep 1)
- [0:00](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=0) Early surgical interventions: gastrostomy tubes and peritoneal dialysis catheters (Ep 2)
- [3:35](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=215) Timing and approach for renal transplantation in infants (Ep 2)
- [5:45](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=345) Technical discussion: gastrostomy tube placement considerations (Ep 2)
- [11:50](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=710) Anatomical observations: small stomach phenomenon in bladder outlet obstruction (Ep 2)
- [0:00](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=0) Early surgical interventions: G-tube and PD catheter placement (Ep 3)
- [3:28](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=208) Infant renal transplantation technique and complications (Ep 3)
- [6:40](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=400) G-tube placement strategy and anatomic considerations (Ep 3)
- [0:00](https://qa.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://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=370) Case Presentation: Severe Posterior Urethral Valves with Recovery (Ep 4)
- [12:43](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=763) Medical Management of Advanced Chronic Kidney Disease in Infants (Ep 4)
- [17:35](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1055) Chronic Kidney Disease Staging and Guidelines in Infants (Ep 4)
- [21:03](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1263) Dialysis Indications and Transplant Planning (Ep 4)
- [25:35](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1535) Q&A: Pulmonary Prognosis, Peritonitis Management, and Nutrition (Ep 4)
- [0:12](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=12) Introduction and Obstructive Sleep Apnea in Obese Surgical Patients (Ep 5)
- [7:54](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=474) Long-term Surveillance After Esophageal Atresia Repair (Ep 5)
- [13:22](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=802) Gas Embolism During Neonatal Laparoscopy (Ep 5)
- [24:24](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1464) Thromboelastography in Pediatric Trauma (Ep 5)
- [29:00](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1740) CDH Readiness Criteria and Pulmonary Hypertension Management (Ep 5)
- [41:00](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2460) Conservative Management of Spontaneous Pneumothorax (Ep 5)
- [51:38](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3098) Balanced Resuscitation in Pediatric Trauma (Ep 5)
- [60:01](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3601) Peritoneal Dialysis Catheter Placement Guidelines (Ep 5)
- [68:21](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4101) Hemodialysis Access: Fistula versus Catheter (Ep 5)
- [75:42](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4542) Newer Biologic Agents for Inflammatory Bowel Disease and Androgen Insensitivity Management (Ep 5)
- [0:00](https://qa.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://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=0) Introduction and Titanic Index for Pectus Excavatum (Ep 7)
- [2:07](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=127) Early Peritoneal Dialysis After Infant Cardiac Surgery (Ep 7)
- [2:59](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=179) Button Battery Ingestion Risk Score (Ep 7)
- [0:00](https://qa.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 8)
- [0:00](https://qa.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 9)
- [0:00](https://qa.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 10)
- [0:00](https://qa.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 11)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "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://qa.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://qa.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://qa.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://qa.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://qa.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://qa.library.globalcastmd.com/watch/early-peritoneal-dialysis-and-postoperative-outcomes-in-infants-after-pediatric-cardiac-surgery-7220?t=30)
- "1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery" — Lizzie Lee (epidemiological) [Ep 8 · 0:07](https://qa.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 8 · 0:14](https://qa.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 8 · 0:14](https://qa.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 8 · 0:23](https://qa.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 8 · 0:33](https://qa.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 8 · 0:33](https://qa.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 8 · 0:39](https://qa.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 8 · 0:44](https://qa.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 9 · 0:07](https://qa.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 9 · 0:14](https://qa.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 9 · 0:14](https://qa.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 9 · 0:23](https://qa.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 9 · 0:33](https://qa.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 9 · 0:33](https://qa.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 9 · 0:39](https://qa.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 9 · 0:44](https://qa.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 10 · 0:07](https://qa.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 10 · 0:14](https://qa.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 10 · 0:14](https://qa.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 10 · 0:23](https://qa.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 10 · 0:33](https://qa.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 10 · 0:33](https://qa.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 10 · 0:39](https://qa.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 10 · 0:44](https://qa.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 11 · 0:07](https://qa.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 11 · 0:14](https://qa.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 11 · 0:14](https://qa.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 11 · 0:23](https://qa.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 11 · 0:33](https://qa.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 11 · 0:33](https://qa.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 11 · 0:39](https://qa.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 11 · 0:44](https://qa.library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=44)
- "Infants with renal failure are often called for gastrostomy tube and peritoneal dialysis catheter placement within the first few days of life." — Alonso (clinical) [Ep 2 · 0:13](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=13)
- "Babies that make urine are not likely to need peritoneal dialysis immediately but are likely to need it in the future." — Alonso (clinical) [Ep 2 · 0:31](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=31)
- "Peritoneal dialysis catheters should ideally be left alone for a couple of weeks after placement if possible." — Alonso (clinical) [Ep 2 · 0:49](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=49)
- "Gastrostomy tube placement is focused along the lesser curvature or close to it to preserve stomach tissue for potential future bladder augmentation by Doctor Reddy." — Alonso (clinical) [Ep 2 · 0:49](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=49)
- "Gastrostomy tube placement is performed laparoscopic-assisted to visualize exact stomach location, then the camera is turned into the pelvis to position the PD catheter." — Alonso (clinical) [Ep 2 · 1:21](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=81)
- "The nephrology team is generally good at predicting which babies will need a peritoneal dialysis catheter." — Alonso (opinion) [Ep 2 · 1:42](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=102)
- "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." — Alonso (clinical) [Ep 2 · 2:04](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=124)
- "Inguinal and umbilical hernias can develop when babies are on peritoneal dialysis." — Alonso (clinical) [Ep 2 · 3:03](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=183)
- "Hernias in dialysis patients are generally left alone if they are not affecting dialysis mechanics or causing symptoms." — Alonso (clinical) [Ep 2 · 3:03](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=183)
- "The ideal weight for infant renal transplantation is around 10 kg if the patient is not on peritoneal dialysis." — Alonso (clinical) [Ep 2 · 3:46](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=226)
- "Infants on peritoneal dialysis have a more accommodating abdominal cavity and laxity in the abdominal wall, allowing transplantation at weights closer to 8 kg." — Alonso (clinical) [Ep 2 · 4:08](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=248)
- "All infant renal transplant recipients at this center have been transplanted with adult donor kidneys." — Alonso (clinical) [Ep 2 · 4:24](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=264)
- "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 2 · 4:39](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=279)
- "Wound complications are the biggest complication from a general surgical perspective in infant renal transplantation, surprisingly more common than vascular complications." — Alonso (clinical) [Ep 2 · 5:06](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=306)
- "Some infant transplant patients can only be closed at the skin level initially and develop leaks or dehiscence requiring biologic mesh (such as derma matrix) for closure." — Alonso (clinical) [Ep 2 · 5:15](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=315)
- "In a 13-year follow-up study of gastrostomy tubes in babies, all G-tubes migrated superiorly onto the chest wall." (clinical) [Ep 2 · 7:21](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=441)
- "Placing gastrostomy tubes too close to peritoneal dialysis catheters creates infection risk early on because drainage can get underneath the PD catheter dressing when there is insufficient space between sites." — Alonso (clinical) [Ep 2 · 7:54](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=474)
- "The standard gastrostomy tube insertion site is 2 finger breadths below the costal margin." — Alonso (clinical) [Ep 2 · 8:31](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=511)
- "For patients with posterior urethral valves, gastrostomy tube location is placed high on the stomach toward the lesser curvature to preserve the ability to use a gastric segment for gastric augmentation later in life." (clinical) [Ep 2 · 8:48](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=528)
- "Some infants with posterior urethral valves will need urinary diversion with a vesicostomy placed about 1-2 finger breadths below the umbilicus, requiring mitigation of infection risks by spacing catheter sites appropriately." (clinical) [Ep 2 · 9:13](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=553)
- "Peritoneal dialysis catheters can be placed in a way that allows immediate use with lower volumes, though waiting for healing is preferable." — Alonso (clinical) [Ep 2 · 11:27](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=687)
- "Many infants with bladder outlet obstruction have unusually small stomachs, potentially related to minimal amniotic fluid during development." (host_summary) [Ep 2 · 11:50](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=710)
- "Amnioinfusions 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://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=750)
- "Early onset large bladders that extend upward and push the diaphragm and stomach back may cause anatomical distortion that results in stomachs ending up higher long-term." (opinion) [Ep 2 · 13:23](https://qa.library.globalcastmd.com/watch/renal-transplantation-cincinnati-fetal-center-623?t=803)
- "Infants who make urine are not likely to need peritoneal dialysis immediately but will likely need it in the future" (clinical) [Ep 3 · 0:25](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=25)
- "When placing both G-tube and PD catheter together, the PD catheter should be left alone for a couple of weeks if possible" (clinical) [Ep 3 · 0:45](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=45)
- "Gastrostomy tube placement should focus on the lesser curvature to preserve the stomach for potential future bladder augmentation" (clinical) [Ep 3 · 0:54](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=54)
- "Hemodialysis catheters need to be fairly large caliber and placement should stay as much as possible to the right internal jugular site because that is a straight shot into the atrium" (clinical) [Ep 3 · 2:11](https://qa.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" (clinical) [Ep 3 · 2:56](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=176)
- "If hernias are not affecting the mechanics of dialysis and not particularly symptomatic, they tend to be left alone" (clinical) [Ep 3 · 2:56](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=176)
- "The ideal weight for infant renal transplant is around 10 kg if not on PD" (clinical) [Ep 3 · 4:01](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=241)
- "Infants on PD can be transplanted closer to 8 kg because they have a more accommodating abdominal cavity and laxity in the abdominal wall" (clinical) [Ep 3 · 4:01](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=241)
- "All infant recipients have been transplanted with adult donors" (clinical) [Ep 3 · 4:17](https://qa.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" (clinical) [Ep 3 · 4:32](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=272)
- "The biggest complication from a general surgical perspective in infant renal transplants are wound complications as opposed to vascular complications" (clinical) [Ep 3 · 4:59](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=299)
- "Some infants can only have skin closed initially and develop leaks or dehiscence requiring biologic mesh (such as derma matrix) for closure" (clinical) [Ep 3 · 5:08](https://qa.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://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=434)
- "Placing G-tube too close to PD catheter creates infection risk early on because there is not enough space between sites and drainage can get underneath the PD catheter dressing" (clinical) [Ep 3 · 7:47](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=467)
- "Standard G-tube insertion site is 2 finger breadths below the costal margin" (clinical) [Ep 3 · 8:24](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=504)
- "In small babies, G-tube should be placed 3 or 4 finger breadths below costal margin because it will rise up with growth" (clinical) [Ep 3 · 8:32](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=512)
- "G-tube location should be high up on the stomach towards lesser curvature to allow ability to use gastric segment for gastric augmentation later in life" (clinical) [Ep 3 · 8:46](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=526)
- "Some babies with posterior urethral valves will need urinary diversion with vesicostomy about 1-2 finger breadths below the umbilicus, requiring G-tube placement away from this site to mitigate infection risk" (clinical) [Ep 3 · 9:06](https://qa.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 rather than waiting 3-7 days" (clinical) [Ep 3 · 11:20](https://qa.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" (host_summary) [Ep 3 · 11:43](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=703)
- "Amnioinfusions are performed when patients present for first imaging to assess the baby's capacity to swallow and see if the stomach fills" (clinical) [Ep 3 · 12:23](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=743)
- "In fetal imaging, bladder and bladder wall thickness and isthmus are always measured" (clinical) [Ep 3 · 12:49](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=769)
- "Early onset large bladders that extend up and push the diaphragm and stomach back may cause anatomic distortion that results in stomachs ending up higher long term" (opinion) [Ep 3 · 13:16](https://qa.library.globalcastmd.com/watch/renal-transplantation-fetal-genitourinary-disease-2015-915?t=796)
- "If amniotic fluid levels are restored to normal through shunting or amnioinfusion, the likelihood of pulmonary survival increases to approximately 80%." — Paul Kingma (clinical) [Ep 1 · 2:42](https://qa.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 pulmonary outcome is poor." — Paul Kingma (clinical) [Ep 1 · 3:08](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=188)
- "Many infants who are pulmonary survivors have reduced reserve lung function, similar to reduced reserve renal function, and can rapidly transition from pulmonary survivor to non-survivor if injured." — Paul Kingma (clinical) [Ep 1 · 5:33](https://qa.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 have developed chronic lung disease after delivery, demonstrating they are not normal from a respiratory standpoint." — Paul Kingma (clinical) [Ep 1 · 6:00](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=360)
- "Any kind of urine output is much better than no urine output, even if the urine is of poor quality and does not contain cleared metabolites." — Jan Scober (clinical) [Ep 1 · 10:32](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=632)
- "Babies with obstructive uropathy often have a concentrating defect and produce large volumes of urine." — Jan Scober (clinical) [Ep 1 · 11:03](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=663)
- "Hypertension is not commonly seen in these babies because they have high urine output and are not volume overloaded, and they tend to lose sodium due to tubular dysfunction." — Jan Scober (clinical) [Ep 1 · 15:37](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=937)
- "Normal GFR for a newborn at 1 month of age is about 50, and it takes a whole year to reach what is accepted as normal GFR in older individuals, which is about 100." — Jan Scober (clinical) [Ep 1 · 19:48](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1188)
- "Reasonable predictions based on clearance and creatinine cannot be made until a patient has spent the first year of life establishing their kidney function." — Jan Scober (clinical) [Ep 1 · 20:14](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1214)
- "The GFR criteria in chronic kidney disease guidelines do not apply to children less than 2 years of age; these children can only be categorized as having normal, moderately reduced, or very severely reduced age-adjusted GFR." — Jan Scober (guideline) [Ep 1 · 20:42](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1242)
- "Dialysis is indicated when chronic kidney disease management fails, specifically when the baby stops growing (including head circumference) or when hyperkalemia or metabolic acidosis cannot be medically managed." — Jan Scober (clinical) [Ep 1 · 22:42](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1362)
- "Peritoneal dialysis is the technically least difficult way to provide dialysis in small children." — Jan Scober (clinical) [Ep 1 · 23:27](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1407)
- "Urine output remains a significant advantage because it is very difficult to manage fluid balance with dialysis alone if there is no residual diuresis." — Jan Scober (clinical) [Ep 1 · 25:17](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1517)
- "At this center, the size required for safe transplantation is typically between 8 and 10 kg, which usually occurs in the second year of life." — Jan Scober (clinical) [Ep 1 · 13:24](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=804)
- "Lower urinary tract management aims to reduce the risk of urinary tract infection through antibiotic prophylaxis and bladder irrigations, and to manage bladder pressure with anticholinergics and catheterization programs guided by urodynamic studies." — Jan Scober (clinical) [Ep 1 · 13:53](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=833)
- "Obstructive uropathy bladders can be very high pressure and can change over time, requiring regular follow-up and potentially changing management strategies." — Jan Scober (clinical) [Ep 1 · 14:52](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=892)
- "If parents want aggressive care, full respiratory support should be provided for at least the first 3 to 4 days, as many infants requiring high levels of support (including oscillator or pulmonary vasodilators) will begin to improve after this period." — Paul Kingma (clinical) [Ep 1 · 27:46](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1666)
- "If the baby is not showing signs of stabilizing and improving after the first 3 to 4 days, the reality that the infant is likely not a pulmonary survivor must be discussed with parents." — Paul Kingma (clinical) [Ep 1 · 28:15](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1695)
- "The question of pulmonary survival must be readdressed anytime there is an episode of lung injury, such as from sepsis." — Paul Kingma (clinical) [Ep 1 · 28:44](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1724)
- "When peritoneal dialysis is not available due to peritonitis, short-term hemodialytic strategies can be attempted, though they are challenging due to the need for blood priming and large catheters in small blood vessels." — Jan Scober (clinical) [Ep 1 · 30:04](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1804)
- "Aquapheresis (ultrafiltration with convective clearance) using slightly smaller catheters has been successfully used to maintain an anuric baby with intraperitoneal problems." — Jan Scober (clinical) [Ep 1 · 30:22](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1822)
- "Temporary hemodialysis catheters in newborns are difficult to maintain because there is not much catheter design for small children, resulting in excess extravascular catheter that moves despite securing, and the 8 French catheter is limited to jugular veins." — Maria Alonso (clinical) [Ep 1 · 31:27](https://qa.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 local thrombosis or stenosis in the central circulation." — Maria Alonso (clinical) [Ep 1 · 31:53](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1913)
- "Nutrition in babies with urine output is easier than in oliguric or anuric babies because the formula does not need to be as concentrated." — Jan Scober (clinical) [Ep 1 · 32:34](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1954)
- "High-output babies lose electrolytes and may require supplementation of potassium and phosphorus, which are typically restricted in older chronic kidney disease patients." — Jan Scober (clinical) [Ep 1 · 32:49](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1969)
- "The density of formula is essentially an inverse function of urine output." — Jan Scober (clinical) [Ep 1 · 33:12](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=1992)
- "The need to provide adequate protein intake may necessitate dialysis in some babies because their BUN cannot be managed otherwise." — Jan Scober (clinical) [Ep 1 · 33:50](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2030)
- "It is relatively unusual to expect these babies to drink spontaneously in amounts sufficient to supply adequate nutrition." — Jan Scober (clinical) [Ep 1 · 34:15](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2055)
- "Breast milk can be incorporated into specialized formulas that meet the baby's specific needs when mothers are motivated to provide it." — Jan Scober (clinical) [Ep 1 · 34:31](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2071)
- "The majority of these children have an NG tube or gastrostomy tube, which they keep even around transplant time for medication administration." — Jan Scober (clinical) [Ep 1 · 34:45](https://qa.library.globalcastmd.com/watch/managing-advanced-chronic-kidney-disease-cincinnati-fetal-center-622?t=2085)
- "In fetal genitourinary disease, pulmonary survival is the critical first question that determines whether renal outcomes matter, yet it is frequently overlooked in discussions focused on kidney function." (opinion) [Ep 4 · 0:28](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=28)
- "When amniotic fluid levels are restored to normal through shunting or amnioinfusion, the likelihood of pulmonary survival increases significantly to approximately 80%." (clinical) [Ep 4 · 1:36](https://qa.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 despite intervention, pulmonary outcomes are poor." (clinical) [Ep 4 · 2:03](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=123)
- "Determining pulmonary survivor status after delivery is complex because multiple postnatal factors can affect outcomes: sepsis-related lung injury, nutritional status affecting lung growth, and ventilator-induced barotrauma." (clinical) [Ep 4 · 3:12](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=192)
- "Being a pulmonary survivor does not mean normal respiratory function; many infants have reduced lung reserve similar to reduced renal reserve and can rapidly decompensate with additional injury." (clinical) [Ep 4 · 4:27](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=267)
- "Some infants with prenatal renal problems who had amniotic fluid replacement and normal fluid levels still developed chronic lung disease after delivery, demonstrating they are not respiratory-normal." (clinical) [Ep 4 · 4:51](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=291)
- "Any kind of urine output, even poor-quality urine that is mostly water without cleared metabolites, is much better than no urine for both prenatal and postnatal management." — Jan Scober (clinical) [Ep 4 · 9:26](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=566)
- "Infants with obstructive uropathy often have a concentrating defect and produce large volumes of urine, which may be poor quality but is still beneficial as fluid." — Jan Scober (clinical) [Ep 4 · 9:46](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=586)
- "Lower urinary tract management in infants with obstructive uropathy requires collaboration with pediatric urologists and includes antibiotic prophylaxis, bladder irrigations, and bladder pressure management with anticholinergics and catheterization programs." — Jan Scober (clinical) [Ep 4 · 12:48](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=768)
- "Obstructive uropathy bladders can have very high pressure and can change over time, requiring regular urodynamic studies and potentially changing management strategies." — Jan Scober (clinical) [Ep 4 · 13:40](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=820)
- "Infants with chronic kidney disease from obstructive uropathy typically do not have significant hypertension because they have high urine output and are not volume overloaded, and they lose sodium due to tubular dysfunction." — Jan Scober (clinical) [Ep 4 · 14:33](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=873)
- "Chronic kidney disease management in infants requires supplementation of erythropoietin and iron to prevent anemia, which has negative cognitive, energy, and quality-of-life effects." — Jan Scober (clinical) [Ep 4 · 15:13](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=913)
- "Untreated secondary hyperparathyroidism from advanced CKD impairs bone and skeletal health, which is especially problematic in growing children." — Jan Scober (clinical) [Ep 4 · 15:47](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=947)
- "Advanced chronic kidney disease not requiring dialysis often causes metabolic acidosis, which is harmful to growth and well-being and requires buffering with citrate supplementation." — Jan Scober (clinical) [Ep 4 · 16:03](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=963)
- "Specialized nutrition management in infant CKD includes formula modification and pre-treatment with potassium-binding resins to prevent hyperkalemia." — Jan Scober (clinical) [Ep 4 · 16:20](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=980)
- "Infants with advanced CKD have feeding and swallowing difficulties and require occupational therapy, physical therapy, and feeding team involvement for developmental support." — Jan Scober (clinical) [Ep 4 · 16:44](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1004)
- "Standard chronic kidney disease staging based on GFR does not apply to children under 2 years of age because normal infants spend their first year developing normal kidney function, with GFR rising from about 50 at one month to about 100 by one year." — Jan Scober (clinical) [Ep 4 · 18:25](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1105)
- "Guideline writers accept that GFR criteria for CKD staging don't apply to children less than 2 years of age; these children can only be categorized as having normal, moderately reduced, or very severely reduced age-adjusted GFR." — Jan Scober (host_summary) [Ep 4 · 19:36](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1176)
- "Dialysis for small children remains challenging but has improved in outcomes and feasibility and should be discussed with families on an individualized basis." — Jan Scober (host_summary) [Ep 4 · 20:37](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1237)
- "The decision to initiate dialysis is based on failed chronic kidney disease management—inability to support growth (including head circumference) or medically manage hyperkalemia or metabolic acidosis—not on creatinine level alone." — Jan Scober (clinical) [Ep 4 · 21:39](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1299)
- "Peritoneal dialysis is the modality of choice for infant dialysis because it is the technically least difficult approach in small children." — Jan Scober (clinical) [Ep 4 · 22:22](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1342)
- "Peritoneal dialysis introduces a major additional layer of complexity and quality-of-life burden for parents, who are typically taught to perform dialysis at home." — Jan Scober (clinical) [Ep 4 · 23:04](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1384)
- "When counseling parents about infant dialysis, the focus should be on the length of time it may be needed (until the child reaches transplantable size at 8-10 kg, typically in the second year of life) and the complexity of the therapy package." — Jan Scober (opinion) [Ep 4 · 23:26](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1406)
- "Parents typically report that when their baby requires complex care including dialysis, one parent usually stops working and caring for the baby becomes their full-time job." — Jan Scober (clinical) [Ep 4 · 23:47](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1427)
- "Residual urine output is a major advantage in managing fluid balance during dialysis; it is very difficult to manage fluid balance with dialysis alone without some residual diuresis." — Jan Scober (clinical) [Ep 4 · 24:11](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1451)
- "It is difficult to justify placing a patient on chronic dialysis without some prospect of transplantation, as this creates a never-ending one-way street that becomes very challenging." — Jan Scober (opinion) [Ep 4 · 24:26](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1466)
- "At this center, infants are typically transplantable at a size between 8 and 10 kg, which usually occurs in the second year of life." — Jan Scober (clinical) [Ep 4 · 12:29](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=749)
- "For aggressive pulmonary care in infants with genitourinary disease, whatever respiratory support is needed should be provided for at least the first 3 to 4 days, as many infants requiring high levels of support (including oscillator or pulmonary vasodilators) will begin to improve after this period." (clinical) [Ep 4 · 26:40](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1600)
- "If an infant is not showing signs of stabilizing and improving by 3 to 4 days of life, discussion with parents about the reality that the infant is likely not a pulmonary survivor is necessary." (clinical) [Ep 4 · 27:04](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1624)
- "The question of pulmonary survival may need to be revisited later, most frequently in the setting of sepsis, where infants on peritoneal dialysis who develop infection can progress from room air to ventilator dependence and never be weaned." (clinical) [Ep 4 · 27:39](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1659)
- "When peritoneal dialysis is not available due to peritonitis, short-term hemodialytic strategies can be attempted but are challenging because they require blood priming of circuits and very large catheters in small blood vessels." — Jan Scober (clinical) [Ep 4 · 28:58](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1738)
- "Aquaphoresis (ultrafiltration with convective clearance) using slightly smaller catheters than hemodialysis has been successfully used to maintain anuric babies with intraperitoneal problems or those requiring major abdominal surgeries." — Jan Scober (clinical) [Ep 4 · 29:16](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1756)
- "Temporary hemodialysis catheters in newborns are difficult to maintain because there is limited catheter design for small children, resulting in excess extravascular catheter length that moves despite securing attempts." (clinical) [Ep 4 · 30:22](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1822)
- "Hemodialysis catheters in newborns are 8 French in size and are limited to jugular vein placement; even tunneled catheters are likely to cause local thrombosis or central circulation stenosis." (clinical) [Ep 4 · 30:44](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1844)
- "Nutrition management is easier in infants with urine output compared to oliguric or anuric infants because formula does not need to be as concentrated." — Jan Scober (clinical) [Ep 4 · 31:28](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1888)
- "High-output infants with CKD lose electrolytes including potassium and phosphorus, requiring supplementation of electrolytes that are typically restricted in older CKD patients." — Jan Scober (clinical) [Ep 4 · 31:43](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1903)
- "Formula density for infants with CKD is inversely related to urine output volume." — Jan Scober (clinical) [Ep 4 · 32:06](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1926)
- "Dietitians calculate required calories for growth and required protein intake while ensuring BUN does not reach dangerously high levels; the inability to provide adequate protein without excessive BUN may necessitate dialysis." — Jan Scober (clinical) [Ep 4 · 32:18](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1938)
- "It is relatively unusual to expect infants with advanced CKD to drink spontaneously in amounts sufficient to supply required nutrition." — Jan Scober (clinical) [Ep 4 · 32:45](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1965)
- "Breast milk from motivated mothers can be incorporated into specialized formulas that meet the infant's specific nutritional needs; this is typically pumped breast milk." — Jan Scober (clinical) [Ep 4 · 33:03](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=1983)
- "The majority of infants with advanced CKD have either an NG tube or gastrostomy tube for feeding, which is maintained even around transplant time for medication administration." — Jan Scober (clinical) [Ep 4 · 33:39](https://qa.library.globalcastmd.com/watch/fetal-management-of-advanced-chronic-kidney-disease-fetal-genitourinary-916?t=2019)
- "In the last 40 years, the prevalence of obesity has gone to over 18% of children worldwide" — Liz Byerly (epidemiological) [Ep 5 · 6:39](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=399)
- "Kids who are obese and receiving therapy for DVT require closer monitoring of their enoxaparin levels because they can have altered drug metabolism due to obesity" — Liz Byerly (clinical) [Ep 5 · 7:24](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=444)
- "NASPGHAN and European counterparts recommend screening endoscopy at 10 years of age for esophageal atresia patients, whether or not they're on anti-reflux medications" — Liz Byerly (host_summary) [Ep 5 · 10:38](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=638)
- "NASPGHAN guidelines recommend screening endoscopy in early adulthood for esophageal atresia patients, and then every 5 to 10 years for adults" — Liz Byerly (host_summary) [Ep 5 · 11:10](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=670)
- "A significant number of children with repaired esophageal atresia will have esophageal metaplasia or Barrett's esophagus, and symptoms often do not correlate with pathology" — Liz Byerly (clinical) [Ep 5 · 11:22](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=682)
- "Studies from the Netherlands and Finland showed an increased risk of esophageal carcinoma in patients with repaired esophageal atresia" — Liz Byerly (host_summary) [Ep 5 · 12:00](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=720)
- "The most likely cause of cardiac arrest during laparoscopy in neonates is pneumopericardium from extraperitoneal insufflation" — Liz Byerly (clinical) [Ep 5 · 16:22](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=982)
- "A survey of pediatric surgeons in the United States found that 28% had experienced gas embolism during neonatal laparoscopy" — Liz Byerly (host_summary) [Ep 5 · 16:44](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1004)
- "The problem occurs because insufflation tubing contains air with nitrogen, which is not soluble in blood, unlike carbon dioxide. It's like the baby gets the bends when you insufflate all that air" — Liz Byerly (clinical) [Ep 5 · 17:52](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1072)
- "End-tidal CO2 is the most sensitive detector of a gas embolism during laparoscopic surgery" — Liz Byerly (clinical) [Ep 5 · 17:14](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1034)
- "Prevention strategies include turning gas on and flushing tubing of air before connecting it to the patient, which decreases the amount of nitrogen and air delivered" — Liz Byerly (clinical) [Ep 5 · 19:09](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1149)
- "On thromboelastography, if R time is abnormal, the patient needs FFP. If alpha angle is abnormal, administer cryoprecipitate. If maximum amplitude is abnormal, give platelets. If LY30 shows excessive fibrinolysis, give aminocaproic acid or tranexamic acid" — Liz Byerly (clinical) [Ep 5 · 27:03](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=1623)
- "Canadian CDH Collaborative readiness criteria for surgery include normal blood pressure for age, urine output >1cc/kg/hr, serum lactate <3, FiO2 <50%, preductal saturation around 90%, and pulmonary artery pressures less than systemic" — Eric Skarsgard (host_summary) [Ep 5 · 37:49](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2269)
- "Surgery is a stressor on the pulmonary vascular bed in CDH patients, so we want to see pulmonary artery pressures trending down and less than systemic pressures before operating" — Eric Skarsgard (clinical) [Ep 5 · 38:20](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2300)
- "For CDH patients with predominantly right ventricular dysfunction on echo, treatment options are nitric oxide, sildenafil, and increasingly PGE1, which maintains the ductus open and allows a pop-off vent for the right ventricle" — Eric Skarsgard (clinical) [Ep 5 · 39:47](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=2387)
- "A randomized trial of spontaneous pneumothorax showed roughly equivalent lung re-expansion by 8 weeks (high 90%) between conservative management and intervention groups" — Eric Skarsgard (host_summary) [Ep 5 · 50:13](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3013)
- "The spontaneous pneumothorax trial showed a threefold increase in adverse events in the interventional group, including bleeding, need for catheter repositioning, and continuing air leaks" — Eric Skarsgard (host_summary) [Ep 5 · 50:22](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3022)
- "The spontaneous pneumothorax trial showed a twofold increase in twelve-month recurrence rates for patients who received intervention versus conservative management" — Eric Skarsgard (host_summary) [Ep 5 · 50:50](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3050)
- "ATLS 10th edition guidelines recommend limiting crystalloid to not more than 20cc per kilogram in pediatric trauma resuscitation" — Eric Skarsgard (host_summary) [Ep 5 · 56:18](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3378)
- "Giving excessive crystalloid worsens dilutional coagulopathy and increases metabolic acidosis in trauma patients" — Eric Skarsgard (clinical) [Ep 5 · 56:37](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3397)
- "Military data from Afghanistan and Iraq showed that increased use of massive transfusion protocols in pediatric trauma patients correlated with decreased mortality between 2001 and 2013" — Eric Skarsgard (host_summary) [Ep 5 · 57:18](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3438)
- "Early balanced blood product resuscitation (red cells, platelets, and plasma) results in using less blood products overall and significantly improved mortality and morbidity outcomes" — Eric Skarsgard (host_summary) [Ep 5 · 57:58](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3478)
- "Military studies clearly show a survival advantage from use of tranexamic acid in trauma patients" — Eric Skarsgard (host_summary) [Ep 5 · 58:32](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3512)
- "There is no evidence supporting intentional hypotensive resuscitation as a strategy in pediatric trauma" — Eric Skarsgard (opinion) [Ep 5 · 58:51](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3531)
- "SCOPE Collaborative guidelines for peritoneal dialysis catheter placement include preoperative antibiotic with gram-positive coverage, downward or lateral exit site placement, and no suture at the exit site" — Todd Ponsky (host_summary) [Ep 5 · 60:21](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3621)
- "Failure rates for dialysis access are quite high: 45% within two months for hemodialysis catheters and 30 to 50% for peritoneal dialysis catheters" — Todd Ponsky (host_summary) [Ep 5 · 63:07](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=3787)
- "Analysis of a large international registry shows over 70% of children have a hemodialysis catheter placed and only 26% receive an AV fistula" — Todd Ponsky (host_summary) [Ep 5 · 67:22](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4042)
- "Multiple studies show superior primary and secondary patency rates for AV fistulas compared to catheters in pediatric patients" — Todd Ponsky (host_summary) [Ep 5 · 67:34](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4054)
- "Organizations have recommended considering AV fistula use in children over 20 kg who will require at least 12 months of hemodialysis" — Todd Ponsky (host_summary) [Ep 5 · 68:04](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4084)
- "Half-life of even a living donor kidney is only about 23-24 years, so a 5-year-old receiving a transplant will face retransplant at age 27-28" — Eric Skarsgard (clinical) [Ep 5 · 69:16](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4156)
- "Entyvio (vedolizumab) is a monoclonal antibody targeted at the gut epithelium with a great safety profile in adult studies" — Todd Ponsky (host_summary) [Ep 5 · 73:55](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4435)
- "In a 2017 review of 64 children who had failed anti-TNF therapy, 25 reached steroid-free remission with Entyvio" — Todd Ponsky (host_summary) [Ep 5 · 74:16](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4456)
- "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 Ponsky (host_summary) [Ep 5 · 78:55](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4735)
- "Patients with androgen insensitivity report feeling abnormal after gonadectomy even when given estrogens, because the testes are a source of estrogen as well as testosterone that is converted peripherally" — Todd Ponsky (host_summary) [Ep 5 · 79:12](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4752)
- "Women on estrogens for prolonged periods after gonadectomy have increased cardiovascular risk" — Todd Ponsky (host_summary) [Ep 5 · 79:36](https://qa.library.globalcastmd.com/watch/pdc-2020-practice-gaps-2998?t=4776)
- "The Haller index and correction index are currently primarily used indices for pectus excavatum and tell us about the severity of the deformity." — Ellen Encisco (host_summary) [Ep 7 · 1:12](https://qa.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 (host_summary) [Ep 7 · 1:20](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=80)
- "There is a weak correlation between the Titanic index and the other indices (Haller and correction indices)." — Ellen Encisco (host_summary) [Ep 7 · 1:44](https://qa.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 is going to need for pectus excavatum repair." — Ellen Encisco (host_summary) [Ep 7 · 1:44](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=104)
- "A Titanic index threshold of 66.5% was established, meaning patients with a higher index than that probably needed more than 2 bars for pectus excavatum repair." — Ellen Encisco (host_summary) [Ep 7 · 1:55](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=115)
- "Early initiation of peritoneal dialysis was associated with decreased post-operative mortality in infants after pediatric cardiac surgery." — Alex Halpern (host_summary) [Ep 7 · 2:35](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=155)
- "Early initiation of peritoneal dialysis shortened duration of mechanical ventilation in infants after pediatric cardiac surgery." — Alex Halpern (host_summary) [Ep 7 · 2:41](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=161)
- "Early initiation of peritoneal dialysis shortened length of stay in the ICU in infants after pediatric cardiac surgery." — Alex Halpern (host_summary) [Ep 7 · 2:41](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=161)
- "In a Boston Children's Hospital study of 143 button battery ingestion patients from 2008 to 2021, 24 had severe outcomes." — Cecilia Gigena (host_summary) [Ep 7 · 3:16](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=196)
- "Location of the button battery in the esophagus is an independent predictor for severe outcomes in button battery ingestion." — Cecilia Gigena (host_summary) [Ep 7 · 3:37](https://qa.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 in button battery ingestion." — Cecilia Gigena (host_summary) [Ep 7 · 3:45](https://qa.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 (host_summary) [Ep 7 · 3:49](https://qa.library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=229)

## Changelog
- Sep 9: Summaries and takeaways published for 4 audiences
- Sep 7: Audit reverted — short clips unhidden
- Sep 7: 1 item hidden — never mention Peritoneal Dialysis Access; unhide from the owner view
- 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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