Preparing for PICU fellowship - CVICU

[Linus van Pelt]

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Hello! I come from a smaller program with a small ICU that does not manage cardiac cases. I will be starting a PICU fellowship this July. I was looking for the best 1-2 resources to help me prepare for cardiac patients in the unit. I am looking for study recommendations, and I am interested in hearing from any of you who have been in a similar circumstance. Thank you!

 

[Siverhideo1985]

Amazon product ASIN 0990995119
Pediatric Cardiac Intensive Care Handbook - we use it all the time in our CVICU - it has all the lesions/surgeries and a short summary of acute clinical concerns when they come out of the OR. It's not comprehensive but a great resource for the 10-15 minutes before the case comes back to read up on for starters. It also does a nice job of summarizing relevant clinical concepts.

Currently out of order on amazon but I am sure a good bookstore could order it for you!

 

[SurfingDoctor]

I remember someone recommended this book to me as a fellow. It was kinda basic, but decent...

Amazon product ASIN 0781785006
The reality is though you shouldn't have to buy anything. The fellowship should have the resources for you. Additionally, as practice care guidelines in the CVICU are very institute specific, anything you read in a textbook is unlikely to be helpful for management. Textbooks are great for teaching physiology and basic concept of disease, but the actual management will be hands on.

 

[Stitch]

Make sure to find out what resources your program has readily available. No sense in buying things they will provide.

One of the hardest things for me was visualizing the anatomy and understanding the blood flow pre and post surgical repair. The Field Guide to Congenital Heart Disease and Repair (Everett and Lim) has great pictures. I think there are a couple variations of this type of book and it's worth flipping through.

Nichols is the cardiac physiology textbook I've seen used most often. The first couple chapters really get into cardiac output and shock physiology which is vital. The ECMO red book also has a fantastic (and short) chapter on oxygen delivery. Really in the end, you need to master O2 delivery and shock along with cardiopulmonary interactions. If you can get a grasp of the DO2 equation (DO2= CO x Hgb x SaO2 x 1.3 + 0.003 x PaO2) and the factors that effect it, you'll be in a good position to start.

But there is time, and you will be taught. Don't panic about feeling unprepared.

 

[Linus van Pelt]

Thank you for your suggestions! I appreciate it.

 

[BigRedBeta]

Definitely recommend the Field Guide - best pictures out there. The book @Siverhideo1985 recommended had some chapters written by some cards fellows I was in fellowship with and attendings from where I did fellowship, so I may be biased but it's excellent and very helpful. I used it for some brief board review as well prior to CCM boards.

I also liked this text for knowing the surgical techniques:Amazon product ASIN 1405196521
Probably overkill for a CCM fellow unless you've got some book money to burn. If I was going back to work in a mixed unit at this point, would probably consider getting it though.