ATS Pediatric Core Curriculum 2024: The Role of the Pediatric Pulmonologist in the Intensive Care Unit

Carmen Leon-Astudillo, Department of Pediatrics, Powell Gene Therapy Center, University of Florida College of Medicine, Gainesville, FL, USA.
Moshe Y. Prero, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
Fei J. Dy, Manawa Ha, Starship Child Health Respiratory and Sleep Department, Auckland, NZ.
Jacob Kaslow, Division of Pulmonary Medicine, Vanderbilt University and Vanderbilt University Medical Center, Nashville, TN, USA.
Holly Hoa Vo, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
Tori Endres, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
Ina St Onge, Department of Pediatrics, Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine, USA.
Pelton Phinizy, Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Karan Kumar, Division of Pediatric Critical Care Medicine, Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA.
Stephen Kirkby, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Iris A. Perez, Division of Pediatric Pulmonology and Sleep Medicine, Children's Hospital Los Angeles, Keck School of medicine of the University of Southern California, Los Angeles, CA, USA.
Jane E. Gross, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA.
Caroline U. Okorie, Department of Pediatrics, Stanford Children's Health, Stanford, California, USA.

Document Type

Article

Publication Date

10-1-2025

Journal Title

Pediatric pulmonology

MeSH Headings

Humans; Pulmonary Medicine (education); Child; Curriculum; Pulmonologists; Intensive Care Units, Pediatric; Pediatrics (education); Lung Diseases (therapy, diagnosis); Physician's Role; Respiratory Distress Syndrome (therapy, diagnosis); Critical Care (methods); Hemoptysis (therapy, diagnosis); Asthma (therapy, diagnosis)

Abstract

The American Thoracic Society Core Curriculum updates clinicians annually in relevant topics related to pediatric pulmonary diseases. This is a summary of the Pediatric Pulmonary Medicine Core Curriculum presented at the 2024 American Thoracic Society International Conference. The curriculum focused on clinical topics that are essential to caring for patients in the intensive care unit (ICU), highlighting the specific care of patients with severe asthma, pediatric acute respiratory distress syndrome (PARDS), hemoptysis and pulmonary hemorrhage, serious cardiovascular disease within the cardiac ICU and chronic respiratory failure. In the case of severe asthma, we review risk factors for ICU admission, adjunct pharmacologic therapies and appropriate ventilatory strategies. We discuss the highlights of the recently updated PARDS guidelines are offer further diagnostic stratification including possible and at risk categories to help facilitate early intervention and possibly prevent disease progression. Though relatively rare, pediatric hemoptysis and pulmonary hemorrhage can be devastating clinical scenarios and this review includes the discussion of pharmacologic and bronchoscopic interventions that should be considered in these cases. Additionally, we provide a summary of some of the common respiratory pathophysiology encountered in the cardiac ICU, as well as the diagnostic and therapeutic interventions available to the pulmonologist. Lastly, we review the decision-making considerations when transitioning patients from the ICU to chronic home mechanical ventilation. This manuscript aims to provide basic knowledge regarding each of these topics, in addition to up-to-date literature and resources for practicing pulmonologists and trainees.

First Page

e71329

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