A hemoglobin increase from 8 to 12 can boost oxygen delivery far more than raising oxygen saturation from 88% to 98%—but that doesn’t mean transfusing every child to 12 is the right call. In part one of this pediatric Critical Care Board Review, Dr. Pradip Kamat, Dr. Rahul Damania, and Dr.Monica Gray connect high-yield equations to urgent bedside decisions: when intubation may improve a failing heart, why a normal blood gas can hide impending respiratory failure, and how hyperventilation can lower intracranial pressure while dangerously reducing cerebral blood flow. They also tackle ventilator waveforms, ECMO anticoagulation, transfusion complications, and the test-taking strategies that make physiology easier to apply under pressure.

Show Highlights:

• Board-preparation strategies and physiology-based clinical reasoning
• Oxygen delivery, oxygen content, and hemoglobin’s role
• Cardiac shunts, Qp:Qs, and duct-dependent congenital heart disease
• Cardiopulmonary interactions, ventilation, and hemodynamics
• Rhythm disturbances, CPR, and ECMO perfusion concepts
• Gas exchange, alveolar gas equation, and oxygenation indices
• Ventilator pressures, waveforms, time constants, and dead space
• Cerebral perfusion, traumatic brain injury, and neurologic emergencies
• Neuromuscular respiratory failure, seizures, and brain death assessment
• Anticoagulation, transfusion complications, sickle cell disease, and other hematologic emergencies

Resources:

• American Board of Pediatrics. Pediatric Critical Care Medicine Content Outline. https://www.abp.org/sites/abp/files/outline-critical-care-updated.pdf
• Fuhrman & Zimmerman’s Pediatric Critical Care, 6th ed. (Elsevier) — chapters on cardiopulmonary interactions, respiratory physiology and mechanical ventilation, neurocritical care, and hematologic emergencies. (add chapter numbers)
• Emeriaud G, et al. Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2). Pediatr Crit Care Med. 2023;24(2):143–168.
• Greer DM, et al. Pediatric and Adult Brain Death/Death by Neurologic Criteria Determination: Consensus Guideline. Neurology. 2023.
• Kochanek PM, et al. Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition. Pediatr Crit Care Med. 2019;20(3S Suppl 1):S1–S82.
• American Heart Association & American Academy of Pediatrics. 2025 Pediatric Advanced Life Support Guidelines. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/pediatric-advanced-life-support
• Kapur J, et al. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus (ESETT). N Engl J Med. 2019;381:2103–2113.
• Lacroix J, et al. Transfusion Strategies for Patients in Pediatric Intensive Care Units (TRIPICU). N Engl J Med. 2007;356:1609–1619.
• Valentine SL, et al. Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children (TAXI). Pediatr Crit Care Med. 2018;19(9):884–898.